As we reported last week, Obamacare is moving forward post-election, but many questions still remain about the Affordable Care Act’s implementation. At the forefront of these unknowns are health insurance exchanges, and the November 16th deadline for the states to declare whether they will set up a state-run exchange.
A state health insurance exchange is an online market where Americans will get private health insurance coverage subsidized by the federal government. The state, the federal government, or a combination of the two, can run the exchanges.
Many states, whether openly or not, postponed compliance with the ACA until after the November 6th elections. The Kaiser Family Foundation’s Larry Levitt stated, "It's always been expected that if the president got reelected, a lot of states sitting on the sidelines would realize they don't want the federal government building a state health insurance system. That's what we're seeing happening."
The November 16th deadline still stands, at which time states are expected to submit a “declaration of intent”. But the Department of Health and Human Services (HHS) has announced that states will have until December 14th to file official outlines for how they plan to operate their marketplaces. So far, thirteen states have declared they will run their own exchange.
States not developing and running their own exchanges can either (1) allow the federal government to set up and run the exchange, or, (2) develop one in partnership with the federal government. Partnership exchanges will have until February 15th to file applications.
The state-federal partnership exchange would likely look something like this:
- states handle consumer relations
- states handle oversight of health plans
- federal government takes care of enrollment
- federal government deals with taxpayer help for consumers
One thing is for certain: no matter who runs them, the exchanges are going to be up and running by January 1, 2014. Open enrollment for the new health insurance exchange plans will begin in October 2013.