NCPA - National Center for Policy Analysis

Many States Not Prepared for Health Care Law

October 3, 2012

More than three dozen states could be unprepared or unwilling to set up the insurance marketplaces called for under the 2010 health care law, leaving at least part of the task up to the federal government, according to a new report, says the Washington Post.

  • Thirteen states and the District of Columbia have formally expressed their intention to set up the marketplaces, which are known under the law as health insurance exchanges.
  • But many of the rest of the states are behind in their planning or have decided not to operate exchanges on their own, according to a report from the Health Research Institute, the research arm of PricewaterhouseCoopers's health care consulting business.
  • Even some of the 13 that plan to set up the exchanges might not be ready for enrollment by October 2013, the report says.
  • If a state does not set up an exchange, the federal government will either partner with the state or be the sole operator in that state.

When the law passed, many experts predicted that the vast majority of states would set up their own exchanges. The experts believed states would want to tailor the exchanges to their own populations. But the task has proved exceedingly complicated. Participating states must set up a call center as well as a Web site that allows people to easily find and understand health plans, in much the way that Orbitz and Travelocity help people find airline flights.

  • States must declare their plans to the Department of Health and Human Services by November 16.
  • In addition to the 13 states that have expressed their intent to set up marketplaces, three states have decided to partner with the federal government in forming the exchanges.
  • Eight have opted to leave the task exclusively to federal authorities.

If states do not set up exchanges, the health care law requires the federal government to step in.

U.S. officials say that they will be ready no matter how many states go this route but that they still invite states to play some role in running the exchanges.

Source: Sandhya Somashekhar, "Many States Not Prepared for Health Care Law," Washington Post October 1, 2012. "Health Insurance Exchanges: Long on Options, Short on Time," Health Research Institute, October 2012.


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