§ 18041. State flexibility in operation and enforcement of Exchanges and related requirements
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/usc/title-42/section-18041A research copy — for the controlling text, always check the official state or federal source. Not legal advice.
(a)Establishment of standards
(1)In general The Secretary shall, as soon as practicable after March 23, 2010, issue regulations setting standards for meeting the requirements under this title,1 and the amendments made by this title,1 with respect to—
(A)the establishment and operation of Exchanges (including SHOP Exchanges);
(B)the offering of qualified health plans through such Exchanges;
(C)the establishment of the reinsurance and risk adjustment programs under part E; and
(D)such other requirements as the Secretary determines appropriate.
The preceding sentence shall not apply to standards for requirements under subtitles A and C (and the amendments made by such subtitles) for which the Secretary issues regulations under the Public Health Service Act [42 U.S.C. 201 et seq.].
(2)Consultation In issuing the regulations under paragraph (1), the Secretary shall consult with the National Association of Insurance Commissioners and its members and with health insurance issuers, consumer organizations, and such other individuals as the Secretary selects in a manner designed to ensure balanced representation among interested parties.
(b)State action Each State that elects, at such time and in such manner as the Secretary may prescribe, to apply the requirements described in subsection
(a)shall, not later than January 1, 2014, adopt and have in effect—
(1)the Federal standards established under subsection (a); or
(2)a State law or regulation that the Secretary determines implements the standards within the State.
(c)Failure to establish Exchange or implement requirements
(1)In general If—
(A)a State is not an electing State under subsection (b); or
(B)the Secretary determines, on or before January 1, 2013, that an electing State—
(i)will not have any required Exchange operational by January 1, 2014; or
(ii)has not taken the actions the Secretary determines necessary to implement—
(I)the other requirements set forth in the standards under subsection (a); or
(II)the requirements set forth in subtitles A and C and the amendments made by such subtitles;
the Secretary shall (directly or through agreement with a not-for-profit entity) establish and operate such Exchange within the State and the Secretary shall take such actions as are necessary to implement such other requirements.
(2)Enforcement authority The provisions of section 2736(b) 1 of the Public Health Services 2 Act [42 U.S.C. 300gg–22(b)] shall apply to the enforcement under paragraph
(1)of requirements of subsection (a)(1) (without regard to any limitation on the application of those provisions to group health plans).
(d)No interference with State regulatory authority Nothing in this title 1 shall be construed to preempt any State law that does not prevent the application of the provisions of this title.1
(e)Presumption for certain State-operated Exchanges
(1)In general In the case of a State operating an Exchange before January 1, 2010, and which has insured a percentage of its population not less than the percentage of the population projected to be covered nationally after the implementation of this Act, that seeks to operate an Exchange under this section, the Secretary shall presume that such Exchange meets the standards under this section unless the Secretary determines, after completion of the process established under paragraph (2), that the Exchange does not comply with such standards.
(2)Process The Secretary shall establish a process to work with a State described in paragraph
(1)to provide assistance necessary to assist the State’s Exchange in coming into compliance with the standards for approval under this section.
(Pub. L. 111–148, title I, § 1321, Mar. 23, 2010, 124 Stat. 186.)
Connections127 cite this · traces to 3
Cited by 127 sections · top 60
public-private-law
U.S. Code
register
- NoticesProposed rule
- Rules and RegulationsFinal rule and interpretation
- NoticesFinal rule
- Rules and RegulationsFinal regulations
- Rules and RegulationsNotice of proposed rulemaking
- NoticesDEPARTMENT OF HEALTH AND HUMAN SERVICES
- Proposed RulesNotice; request for comments
- Rules and RegulationsProposed rule
- Rules and RegulationsFinal rule
- Presidential DocumentsFinal rule
- Presidential DocumentsFinal rule
- NoticesFinal rule
- Rules and RegulationsFinal rule
- NoticesFinal rule
- Rules and RegulationsFinal rule
- Presidential DocumentsIntroduction to the Regulatory Plan and the Unified Agenda of Federal Regulatory and Deregulatory Actions
- Proposed RulesNotice of proposed rulemaking and notice of public hearing
- Presidential DocumentsFinal rule
- NoticesNotice
- NoticesProposed rule
- NoticesProposed rule
- Presidential DocumentsIntroduction to the Unified Agenda of Federal Regulatory and Deregulatory Actions
- NoticesFinal rule
- NoticesProposed rule
- NoticesProposed rule
statute-compilations
statutes-at-large
bill
- Sec. 116
- Sec. 2Exchange Web site requirements
- Sec. 2Limitation on auto-enrollment
- Sec. 2Restoring to States the freedom and flexibility to regulate health insurance markets
- Sec. 1Short title; table of contents; contingency and limitation on application
- Sec. 3Restoring to States the freedom and flexibility to regulate health insurance markets
- Sec. 2Preventing bureaucratic workarounds
- Sec. 2Limitation on auto-enrollment
- Sec. 2Limitation on auto-enrollment
- Sec. 3Preventing bureaucratic workarounds
- Sec. 101Ending the one size fits all ACA approach; continuing consumer protection policies by covering adult children, protecting individuals with preexisting conditions, and not applying lifetime or annual limits
- Sec. 2Funding American Health Benefit Exchanges navigator programs and outreach and promotional activities
- Sec. 204Undo Administration sabotage by requiring open enrollment outreach, education, and funding for navigators
- Sec. 304Promote transparency and accountability in the Administration’s expenditures of Exchange user fees
- Sec. 2Preserving State option to implement health care marketplaces
- Sec. 2Preserving State option to implement health care marketplaces
- Sec. 205Federal Exchange outreach and educational activities
- Sec. 303Preserving State option to implement health care marketplaces
- Sec. 304Promote transparency and accountability in the Administration’s expenditures of Exchange user fees
- Sec. 2Funding American Health Benefit Exchanges navigator programs and outreach and promotional activities
- Sec. 2Study by Comptroller General of United States
- Sec. 201Preserving State option to implement health care marketplaces
- Sec. 202Providing for additional requirements with respect to the navigator program
- Sec. 203Federal Exchange outreach and educational activities and annual enrollment targets
- Sec. 205Protection of health insurance coverage in certain Exchanges
11 references not yet in our index
- 1
- 2
- Pub. L. 111–148, title I, § 1321
- 124 Stat. 186
- Pub. L. 111–148
- 124 Stat. 130
- act July 1, 1944, ch. 373
- 58 Stat. 682
- Pub. L. 111–148, § 1563(c)(13)(C)
- 124 Stat. 269
- 124 Stat. 119
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cites case law
§ 18041
State flexibility in operation and enforcement of Exchanges and related requirements
Bills×81
Fed. Reg.×34
U.S.C.×7
Stat. Comp.×2
Stat.×2
Pub. L.×1
Cite1
Cite2
Pub. L.Pub. L. 111–148, title I, § 1321
Stat.124 Stat. 186
Pub. L.Pub. L. 111–148
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