Seven­teen states get OK to run health ex­changes

Modern Healthcare - - LATE NEWS - — Rich Daly

With eight new plans ap­proved, 17 states in all have re­ceived a ten­ta­tive nod from the CMS to op­er­ate their own health in­surance ex­changes while two more will of­fer the in­surance mar­ket­places with fed­eral help. HHS pro­vided con­di­tional ap­proval for seven more states— Cal­i­for­nia, Hawaii, Idaho, Ne­vada, New Mex­ico, Ver­mont and Utah—to op­er­ate state-based ex­changes, and Arkansas was ap­proved to op­er­ate a state part­ner­ship ex­change with the fed­eral government. Ten other states and the District of Columbia had pre­vi­ously re­ceived con­di­tional ap­provals to launch their own ex­changes, while Delaware was ap­proved for a part­ner­ship ex­change. The ex­changes, a cen­tral pil­lar of the Pa­tient Pro­tec­tion and Af­ford­able Care Act, are in­tended to spur in­surer com­pe­ti­tion and ex­pand cov­er­age through pri­vate health in­surance plans not tied to in­di­vid­u­als’ em­ploy­ment. Ex­change-based in­surance plans are ex­pected to pro­vide cov­er­age to 9 mil­lion peo­ple when they launch in 2014 and ex­pand to 26 mil­lion peo­ple by 2022, ac­cord­ing to July es­ti­mates by the Con­gres­sional Bud­get Of­fice. Fed­eral of­fi­cials are plan­ning to launch fed­er­ally op­er­ated ex­changes in states that are not ap­proved ei­ther to op­er­ate their own ex­change or to do so in part­ner­ship with the fed­eral government. The dead­line for states to sub­mit ap­pli­ca­tions to op­er­ate their own ex­changes passed on Dec. 14, 2012, but states still have un­til Feb. 15 to ap­ply for a state part­ner­ship ex­change. Many Repub­li­can gov­er­nors have in­di­cated they will de­cline to par­tic­i­pate in the ex­changes be­cause states will have lit­tle con­trol over them. The only state to ap­ply to op­er­ate an ex­change in part­ner­ship or in­de­pen­dently and not yet re­ceive ten­ta­tive ap­proval was Mis­sis­sippi. CMS of­fi­cials said they sus­pended their con­sid­er­a­tion of that state’s ex­change ap­pli­ca­tion when le­gal ques­tions were raised about whether the state in­surance com­mis­sioner had the le­gal author­ity to sub­mit the ap­pli­ca­tion.

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