Smart Benefits: More States Reject State-Run Health Exchanges
Monday, November 19, 2012
The exchanges, a requirement of federal healthcare reform, are meant to be online marketplaces where uninsured individuals can shop for coverage, find out if they qualify for federal subsidies and compare plans. While many thought President Obama’s re-election would signal states to finally move forward with planning for the exchanges, Nebraska, Texas, Alaska, Indiana, North Carolina and South Carolina have joined 20 other states in declaring that they won’t set up the exchanges but wait for the federal government to intervene instead.
States State Concerns
The states rejecting the state-run exchanges cite a variety of reasons for their opposition, including:
high costs to establish and operate
uncertainty about availability of funding the subsidies for those who would qualify
concerns that the states should not be administering federal laws and that the exchanges should be federally run
Rhode Island Bucks the Trend
Unlike the decision by the six states last week, Rhode Island has been an early adopter of the exchange, moving towards the October 1, 2013, deadline to be operational. That doesn’t mean, however, that it doesn’t have its naysayers.
Some critics claim the Rhode Island exchange agenda has been overly ambitious in some respects. The federal law is intended to help the uninsured and Medicaid eligible population first. But there’s been discussion about the possibility of including small businesses in the Rhode Island exchange immediately as well as making the exchange a single payer system for all employers.
Will Exchanges be Operational by Oct 1, 2013?
With so many states putting up roadblocks to the exchanges, is the federal government ready to start planning them instead? And if that’s the case, can HHS meet its deadline of October 1, 2013, or will the exchanges be delayed until 2015 … or beyond?
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