HHS will accept comments on the proposed regulations for 30 days.
States that do not choose to run their own or partnership exchanges will default to a federally run exchange. Pennsylvania has not yet announced its choice, with state officials repeatedly citing the lack of regulatory guidance as a hindrance.
According to the proposal, the cost of running federal exchanges would be funded by a surcharge on participating insurers – 3.5 percent of monthly premiums in 2014.
The exchanges are to be open to individuals and businesses with fewer than 100 employees in 2014, with enrollment beginning in October 2013. The federal government has given states billions of dollars to start the exchanges, but the exchanges are to be self-supporting by 2015.
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