The White House last week hailed 28 states — led by both Republican and Democratic governors — that “are on their way toward establishing” a health insurance exchange. So far, HHS has issued three rounds of establishment grants, collectively worth up to $729 million. But states might run out of time long before they run out of money.
In less than a year, HHS must certify state insurance exchanges, which will begin enrolling members 10 months later and become operational on Jan. 1, 2014. Moreover, it’s unclear if the federal government will have enough time to create a federal program that can be plugged into states that can’t or won’t do it themselves.
In November, CMS issued a 14-page draft certification application, which states must submit this fall. But HHS hasn’t said much about what the certification process will look like. Given that a majority of states won’t be ready for certification, HHS is expected to set a low bar and focus on assisting states in moving forward, rather than rejecting certification applications. It’s expected that HHS will issue “conditional approval” based on various levels of progress. One key reason for encouraging the states to move forward is the potential costs for HHS to implement a federal exchange in states that haven’t reach the deadlines laid out by the reform law.
Do you think the feds will be ready by 2014 to operate exchanges in states that can’t or won’t do it themselves?
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