U.S. Gives States More Time to Set Up Health Insurance Exchanges01/15/13
TUESDAY, Jan. 15 (HealthDay News) -- The Obama administration is
giving states additional time to set up so-called health insurance
exchanges, a key element of the 2010 health reform law designed to
bring coverage to an estimated 30 million Americans who don't have
Under the law, states were supposed to notify the U.S.
Department of Health and Human Services by Jan. 1 whether they were
planning to establish the online marketplaces.
But Health and Human Services Secretary Kathleen Sebelius said
Monday that she would extend the deadline for any states that
expressed interest in creating their own exchanges or overseeing
insurance sold through a federal exchange,
The New York Timesreported.
The state-based insurance exchanges are a crucial component of
the Patient Protection and Affordable Care Act, the controversial
health reform legislation championed by President Barack Obama.
Each exchange would operate a website where uninsured residents of
the state and small employers can compare various health-plan
options offered by insurance companies, much in the same way that
consumers shop online for hotel rooms and airplane tickets that
suit them best.
By late last month, just 18 states and the District of Columbia
had said they intended to run their own exchanges, Sebelius
In states that choose not to set up an exchange, the federal
government will implement health insurance exchanges, helping the
uninsured gain coverage.
"We're looking forward to Jan. 1, 2014, when consumers and small businesses will be enrolled through the exchanges in private health insurance plans and millions more Americans will have the coverage they need and deserve," Sebelius wrote in a blog posting.
The health reform law is designed to aid some 30 million
uninsured Americans by expanding Medicaid, the publicly run program
that helps the poor obtain medical care; creating subsidies for
lower-income people to buy private coverage; and establishing the
With enrollment for the exchanges set to begin Oct. 1, 2013, the
Obama administration and its contractors face the huge challenge of
building a federal exchange that can be rolled out in states that
have no insurance exchange and creating a central data hub where
states can verify a person's eligibility for tax credits, premium
subsidies and other health programs, such as Medicaid and the
Children's Health Insurance Program.
Although the Affordable Care Act, derided as ObamaCare by its
critics, became law in March 2010, many opponents at the state
level dragged their heels on exchange activities pending the U.S.
Supreme Court's decision last June on the law's constitutionality
and the outcome of the November presidential election. Some states
nixed the exchanges, citing anticipated costs, lack of federal
guidance and outright opposition to the law.
For the most part, states with Republican governors opted to
default to a federal exchange.
"The great irony of this whole thing is you have the majority of the Republican governors really allowing the federal takeover of health care when they could choose to have a state exchange," Dr. Daniel Derksen, chair of public health policy and management at the University of Arizona in Tucson and former director of the New Mexico Office of Health Care Reform, told HealthDay.
But will people notice whether their state or the federal
government is the face behind the exchange?
"From a consumer perspective, whether you have a state-run exchange or a federal exchange doesn't make a huge difference," said Caroline Pearson, a director at Avalere Health LLC, a Washington, D.C.-based consulting firm. In either case, she noted, people will get coverage.
Avalere Health predicts that roughly two-thirds of the 8.2
million people expected to buy coverage through the exchanges in
2014 will do so through a federally administered or partnership
Visit the Henry J. Kaiser Family Foundation's state health facts
web page for details on state participation in
health insurance exchanges.
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