In a letter to the Centers for Medicare and Medicaid on Thursday, Ohio officials confirmed plans to allow the federal government to operate the state's health insurance exchanges.
In opting for a Federally Facilitated Exchange, or FFE, Ohio has ceded the responsibility for running the exchange to the federal government, but will retain control over Medicaid eligibility determinations and its regulatory authority over the state’s insurance markets.
Under the FFE, Ohio can evaluate whether a health plan or issuer meets particular certification standards as part of its established state regulatory role; that state review (assuming it follows HHS’ planned approach) will be relied upon by HHS in making qualified health plan certification decisions. (the January 3, 2013 “Guidance on the State Partnership Exchange” memo from Center for Consumer Information and Insurance Oversight provides more information.)
Consumer assistance for Ohioans will be available through navigators – entities that will assist consumers and small employers with the enrollment process. Under Ohio’s FFE, the federal government will select, train and provide funding to entities participating in the navigator program.
By foregoing a partnership or state-based exchange model, Ohio will not be eligible to obtain federal funds to establish and operate an optional in-person consumer assistance program, an option that acknowledges not all communities or eligible individuals will have easy access to a navigator.