What happens to the health insurance exchanges if the government shuts down this week? The Department of Health and Human Services (HHS) has stated that if the government does in fact shutdown, the public health insurance exchanges will still open tomorrow, October 1, for enrollment.
According to President Barack Obama, “On Tuesday, about 40 million more Americans will be able to finally buy quality, affordable health care, just like anybody else… [The new health insurance exchanges] will be open for business on Tuesday no matter what — even if there’s a government shutdown. That’s a done deal.”
How is this possible?
According to the administration, the government shutdown will not affect mandatory spending, which is not included in the annual appropriations debate taking place in congress right now. Mandatory components of the Affordable Care Act include the health insurance premium subsidies offered through the exchanges as well as Medicaid expansion.
HHS Contingency Plan
HHS released a contingency plan listing out which HHS activities are funded by mandatory spending, and therefore would continue, as usual, in the case of a government shutdown. Among this list were the Centers for Medicare & Medicaid Services (CMS). The plan states: “CMS would continue large portions of ACA activities, including coordination between Medicaid and the Marketplace, as well as insurance rate reviews, and assessment of a portion of insurance premiums that are used on medical services. In the short term, the Medicare Program will continue largely without disruption during a lapse in appropriations. Additionally, other nondiscretionary activities including Health Care Fraud and Abuse Control, Center for Medicare & Medicaid Innovation, and Pre-existing Condition Insurance Plan activities would continue. States will have funding for Medicaid on October 1, due to the advanced appropriation enacted in the FY 2013 appropriations legislation, as well as for the Children’s Health Insurance Program (CHIP).”
The plan goes on to list staff that will not be affected by a hiatus in annual appropriations. Among this list were those employed by:
- ACA Mandatory Program Management
- Center for Medicare and Medicaid Innovation
- ACA Implementation Fund
As for money to pay for the state-run exchanges, the HHS has already granted billions of dollars to the states setting up their own exchanges. According to the administration, this funding is enough to cover staffing as well as implementation, and should keep them running on schedule for weeks, at the minimum.
So, it appears that the public health insurance exchanges will open tomorrow, with or without a government shutdown. For more information on how to sign up for individual insurance through the exchanges, see: How to Sign Up for Individual Health Insurance via the Marketplaces
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