Delaware is the only state in the region that agreed to work with the federal government in forming a health-care exchange under the Affordable Care Act, according to Newsworks.
Both Pennsylvania and New Jersey refused to partner with thefederal government to form health care exchanges. But Delaware has set out to create and run this online health insurance marketplace through a partnership with the feds.
Delaware officials say they will vet the insurance plans offered through the marketplace, whose goal is to enable the uninsured or underinsured to obtain adequate coverage.
Linda Nemes, assistant director of market regulation for the state’s Insurance Department, said Delaware will only accept companies that are solvent. And, state officials will make sure each health plan offers the standard benefits outlined by the federal government under the Affordable Care Act.
Delaware has also added its own requirements for something called “network adequacy” that would ensure that carriers remain within a reasonable travel distance to residents.
Consumers can also expect some in-state help when they have a complaint about an insurance company. But, Nemes said, initial calls will likely first be logged with federal call center.
“Then that would be trickled down to the Department of Insurance,” she said. “We feel we know the needs of the Delaware residents. Also it’s a regulatory issue, it helps us know what the carriers are doing and what the marketplace is doing.”
Delaware is leaving much of the complicated – and expensive – information-technology planning to federal officials. Experts say the government has to build a secure data hub that all states can access.
That central system will need to perform long list of tasks such as: verifying whether a person is a citizen or determining if a buyer qualifies for a subsidy under the Affordable Care Act.