James Madison
Senior Member
1311 says only a State can create an "Exchange". So when 1321 says that the Secretary of Health is to create an "Exchange", it can't unless Obama or the next President nominates North Dakota as the Secretary of Health.Higgins the statute defines State in such a manner as to not include the Secretary of Health and I advised you of this in a prior post. Section 1321 references exchanges established by the Secretary of Health. However, since the SOH isn't within the definition of "State" as defined by the statute, then a 1321 cannot be an exchange established by the State.
How does an Exchange in 1321 overcome the 1311(d)(1) issue?
How, quite easily, a 1321 exchange is a different kind of exchange authorized by section 1321. Section 1311 doesn't state the exchange in 1311 is the only exchange.