States have another month to decide on health insurance pools

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States have a little longer to decide if they will establish their own health insurance exchange required by the Patient Protection and Affordable Care Act, or if they will let the federal government step in and run one for them.

The original deadline for a declaration of intent letter and blueprint for an exchange was Nov. 16, but it has been pushed back as a response to a letter from the Republican Governors Association, Health and Human Services Secretary Kathleen Sebelius writes.

"While receiving a letter of intent now will help us assist states in finalizing their application, a state may submit both a letter of intent and an application to operate its own exchange by December 14," Sebelius said. 

The extension accommodates governors who were waiting until the election's outcome to decide if their states would have to adhere to the ACA or not. If states do not meet the new deadline, the federal government will setup an exchange for them.

HHS will accept plan outlines from states that want a state-federal partnership exchange by Feb. 15, 2013. Sebelius says states will be able to apply to run these exchanges on their own in the future.

Sebelius says HHS wants the exchanges to be ready to accept open enrollment by Oct. 2013 and begin operations on Jan. 1, 2014.

So far, the District of Columbia and 22 states have decided to build their own exchanges or operate them in conjunction with the federal government: California, Colorado, Connecticut, Hawaii, Illinois, Iowa, Kentucky, Maryland, Massachusetts, Michigan, Minnesota, Mississippi Nevada, New Mexico, New York, North Carolina,  Oregon, Rhode Island, Utah, Vermont, Washington and West Virginia.

Some 20 states have said the federal government can build and operate the exchanges for them: Alabama, Alaska, Delaware, Florida, Georgia, Kansas, Louisiana, Maine, Missouri, Montana, Nebraska, New Hampshire, North Dakota, Ohio, South Carolina, South Dakota, Texas, Virginia, Wisconsin and Wyoming.

Eight states appear to have not made up their minds about how the exchanges will be run: Arkansas, Arizona, Oklahoma,  Idaho, Indiana, New Jersey, Pennsylvania and Tennessee.

For more:
- read the letter from Sebelius (.pdf)

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