Limited State Response to Exchange Plan Requirements

Posted by Marla Roshkoff - 25 October, 2012


States have until 2014 to implement Exchanges for the purchase of health insurance coverage. State-based Exchanges must be approved or conditionally approved by the U.S. Department of Health and Human Services by January 1, 2013 and conduct an open enrollment period by October 1, 2013. Health coverage offered through an Exchange must meet federally-established minimum requirements to be considered qualified health plan coverage (QHP).

The U.S. Department of Health and Human Services (HHS) established guidelines for states to follow to develop their health insurance exchanges and set a November 16, 2012 deadline for states to submit their plans to HHS.

HHS gives states three options: (1) establishing a state-run exchange; (2) participating in a partnership exchange (through which states would oversee customer service and/or plan management), or (3) using a federal-run exchange.

States must complete an application and file it with HHS explaining their approach. There are two components of the application: (1) a declaration letter describing the exchange model the state will persue and (2) a complete exchange blueprint.

With the November 16 deadline quickly approaching, it is interesting to note that only 23 states and the District of Columbia have submitted plans. 27 states have chosen not to submit any plans, which means that the federal government will have to step in to run the state exchanges.

Some states may still be holding out hope to see the outcome of the Presidential election on November 6.

Topics: Health Care Reform (ACA)

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