In a reply to July letter from U.S. Department of Health and Human Services Secretary Kathleen Sebelius requesting information about state authority to enforce the provisions in the Affordable Care Act (ACA), the National Association of Insurance Commissioners (NAIC) says states have sufficient power to do so.

“Over the past four months the NAIC has completed several surveys of the states in an attempt to determine states’ ability to enforce the federal consumer protections scheduled to become effective plan years beginning on or after September 23, 2010,” the letter states. “As you can see, almost half of the states have concluded that they have the ability to enforce the federal law either through explicit state laws or general powers granted to the commissioner. In addition, almost all states can use their form approval process, investigative powers, and/or market conduct exam authority to hold licensed insurers accountable for their compliance with the federal laws. This, combined with coordinated enforcement by the federal regulators, should be sufficient to ensure carriers comply with the new requirements.”

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