Although a majority of states are creating their own health insurance exchanges, a few other states have been resistant. Those states will instead rely on a national exchange to be administered by federal health officials.
The Dept. of Health and Human Services announced Nov. 29 that 29 states have made significant progress toward creating health insurance exchanges under the national health system reform law. HHS on Nov. 29 awarded nearly $220 million in grants to 13 states to help them create exchanges.
The exchanges will serve a key role in the health reform law’s expansion of coverage to an additional 30 million people, split about equally between private health plans and Medicaid. These tasks include selecting private health plans to be offered in the exchanges and guiding consumers seeking to enroll in coverage.
Some states, like Minnesota, are taking leading roles in exchange implementation. The Minnesota Dept. of Commerce on Dec. 5 began seeking consumer input on online exchange interfaces designed by five vendors seeking a contract for the work. The department posted the models on its site and will collect feedback on them until Dec. 21. Consumer input will be used to choose the winning bid.
But other states plan to allow federal health officials to take over the work of creating an exchange. Kansas and Oklahoma returned their planning grants because lawmakers were concerned that the grants would commit the states to an undetermined amount of future health spending. Alaska did not apply for a planning grant, and leaders in other states, such as Texas Gov. Rick Perry, have said they will block implementation of a local exchange. Many of these states are suing the federal government to block implementation of the health reform law as a whole.
On Dec. 2, Arkansas became the latest state to opt out of creating its own exchange. Arkansas Insurance Commissioner Jay Bradford said opposition by state lawmakers forced a state exchange steering committee to recommend that Arkansas abandon its implementation efforts.
The health reform law requires states to show significant progress in creating their own exchanges by January 2013. If federal health officials believe that a state will not be ready to operate an exchange by January 2014, the federal government will operate a national exchange to serve these residents. However, states can opt to create their own exchanges after 2014 and take over from the federal government. Read More