HHS Gives States More Time To Decide on Insurance Exchanges
On Thursday, the Obama administration announced that states will have four more weeks to declare whether they intend to run their own health insurance exchange under the Affordable Care Act, The Hill's "Healthwatch" reports (Baker, "Healthwatch," The Hill, 11/15).
Under the ACA, states can operate their own exchange, partner with the federal government or let the government run an exchange for them.
In a letter sent to governors last week, HHS Secretary Kathleen Sebelius said the administration was extending the deadline for states to submit detailed applications -- or blueprints -- required by federal officials to Dec. 14, but the Nov. 16 deadline to notify HHS of their decisions would stand.
Meanwhile, states that intend to partner with the government will have until Feb. 15 to submit their declaration letter and blueprint. Sebelius noted that the extended deadlines would not affect the anticipated launch of the exchanges in January 2014.
On Thursday, Sebelius said states will be able to inform HHS of their decisions on Dec. 14, when they submit their blueprints for how they would operate their exchanges (Blesch/Daly, Modern Healthcare, 11/15).
The second extension came one day after two Republican governors sent a letter to President Obama asking that the administration postpone the deadline until governors' questions about the exchanges have been answered and the exchange rules have been finalized (Millman, Politico, 11/15).
Sebelius announced the extension in a letter to the governors -- Virginia Gov. Bob McDonnell, the outgoing chair of the Republican Governors Association, and Louisiana Gov. Bobby Jindal, the new RGA chair (Modern Healthcare, 11/15). She noted that additional guidance about the exchanges "will be released in the coming days and weeks" (Politico, 11/15).
RGA Responds to Deadline Extension
RGA spokesperson Mike Schrimpf on Thursday said the association "appreciates the administration's acknowledgement that not enough information has been provided to the governors and hope this is a signal that the White House intends to engage directly with the governors on the substantial policy issues that remain unresolved and are open to real reform" (Galewitz, Kaiser Health News, 11/15).
Update on State Decisions
In compliance with the initial Nov. 16 deadline, several state leaders on Thursday announced their decisions on whether they would establish a state-based insurance exchange, CQ HealthBeat reports.
- Indiana: Gov.-elect Mike Pence (R) in a letter to outgoing Gov. Mitch Daniels (R) said he opposes creating a state-based exchange because of the high costs. However, Pence did not indicate whether Indiana would defer to the federal government to operate an exchange (Adams, CQ HealthBeat, 11/15).
- Iowa: Gov. Terry Branstad (R) said he is delaying a decision until the Obama administration provides key details about the exchanges. However, Branstad spokesperson Tim Albrecht said the state is exploring a partnership exchange that could include several states (Alonso-Zaldivar, AP/San Jose Mercury News, 11/15).
- Mississippi: Despite the objections of Gov. Phil Bryant (R), state Insurance Commissioner Mike Chaney (R) on Thursday told HHS that the state will run its own exchange, Kaiser Health News' "Capsules" reports. Chaney said a state-run exchange will allow Mississippi to control the types of health plans that will be offered to residents (Hess, "Capsules," Kaiser Health News, 11/16).
- Nebraska: Gov. Dave Heineman (R) on Thursday announced that his state will opt for a federally run exchange because a state-run exchange would cost Nebraska taxpayers $470 million more over eight years than one operated by the government (Burnett, Omaha World-Herald, 11/15).
- North Carolina: Outgoing Gov. Bev Perdue (D) announced that her state will partner with the federal government to create an exchange, saying "It is critical for our state to participate in decisions that affect our state's citizens." However, she noted that "[i]t remains my goal to pursue a state-based plan." Gov.-elect Pat McCrory (R) has not indicated his position on the exchange.
- South Carolina: Gov. Nikki Haley (R) on Thursday sent a letter to Sebelius saying that her state would rely on the federal government to run its exchange (CQ HealthBeat, 11/15).
As of Thursday evening, 17 states and the District of Columbia have said they will run their own exchanges, five states plan to pursue partnerships with the federal government and 20 states have said they will not operate their own exchanges, according to "Healthwatch."Meanwhile, eight states -- Arizona, Idaho, New Jersey, Oklahoma, Pennsylvania, Tennessee, West Virginia and Wisconsin -- remained undecided before HHS' announcement on Thursday to extend the deadline (Baker/Viebeck, "Healthwatch," The Hill, 11/15). This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.