Health Care Law Blog

Michigan will Pursue Federal Partnership for its Health Insurance Exchange

At the end of August, Governor Rick Snyder announced that Michigan will be pursuing a federal-state partnership for its health insurance exchange.  Health insurance exchanges are a requirement of the federal Health Care Reform law.  Health insurance exchanges are designed to  facilitate the purchase of health insurance by consumers through an online, cost-competitive forum.  Each state has the option to: (1) operate its own health insurance exchange; (2) partner with the federal government; or (3) allow the federal government to manage its health insurance exchange.

Michigan’s prior intention was to create a solely state-run exchange.  Last year, the Michigan Senate introduced a bill proposing a state-run exchange. However, a number of obstacles, including inaction in the Michigan House of Representatives and an impending November 16, 2012, deadline for submission of a state-exchange blueprint, made that goal unattainable at the present time.

The decision to operate under a partnership model means that the federal government will remain accountable for maintaining exchange functionality and ensuring that the exchange meets all required standards.

However, under the federal-state partnership model for health insurance exchanges, Michigan will still have control over a number of features of its exchange and it may choose to operate plan management functions.  Such plan management functions include: plan selection; collection and analysis of plan rate and benefit package information; ongoing issuer account management; and plan monitoring, oversight, data collection and quality analysis.  The federal government under the federal-state partnership model would facilitate the exchange’s eligibility and enrollment functions as well as coordinate oversight of consumer complaints and enrollment reconciliation issues.

Under this model, Michigan may also choose to operate certain consumer assistance functions.  Such functions may include: in-person assistance; navigator management; and outreach and education.  The federal government, however, would operate consumer assistance functions related to call center operations; website management; and written correspondence with consumers to support eligibility and enrollment.

Even though Michigan has chosen to pursue a state-federal partnership model for its exchange at this time, it may still convert to a solely, state-run model in the future.  For more information about Michigan’s efforts in implementing its health insurance exchange, please contact Mindi Johnson at (616) 726-2252 or by using the form below.

Categories: Employee Benefits, Health Care Reform, Health Insurance Exchange, Insurance, Regulatory