New rules under the Patient Protection and Affordable Care Act of 2010 (.pdf) will soon take effect and require state chief information officers to implement health benefit "exchanges," or online marketplaces for individuals seeking to purchase health insurance.

While the Health and Human Services Department has yet to formulate some of the regulations that will govern exchanges, it's already clear that states will have to establish self-sustaining systems by Jan. 1, 2015, says a report (.pdf) released June 2 by the National Association of State Chief Information Officers.

State health benefit exchanges must set up interfaces to federal program information maintained and hosted by the Internal Revenue Services, the Homeland Security Department, the Social Security Administration and HHS.

In order to comply with PPACA and obtain grant money, the exchanges must complete the following information technology-related tasks:

• Operate a toll-free hotline,
• Present plan benefits in a standardized format;
• Provide an electronic calculator to determine the actual cost of coverage, which accounts for tax credit and cost sharing credits;
• Conduct a survey and present enrollee satisfaction information; and
• Open aggregate data to the public through the exchange, among other things.

According to the NASCIO report, state CIOs are currently identifying technology gaps and assessing legacy systems that may connect to the exchange and be in need to upgrades. They're also looking to other states for collaboration opportunities and not-for-profit companies that can assist with implementation.

So far about $296 million worth of grants have been made available to states and territories for health benefit exchange planning and creating, according to NASCIO. "This funding includes the 'Early Innovator' grants that have been awarded to six states and a consortium of states in developing an array of models for exchanges' information technology systems," say report authors.

Massachusetts and Utah, for example, have already successfully created their health benefit exchanges, according to NASCIO.

"While each state may have unique circumstances, it is imperative to consider the similarities that exist in state IT systems. State CIOs should take into consideration the potential savings from the reuse of existing architectures and systems," advised report authors.

For more:
- see the NASCIO report (.pdf)
- see HHS guidance on Health Insurance Exchanges

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