HHS Says 28 States Have Taken Steps on Health Benefit Exchanges

The Obama administration on Wednesday announced that 28 states have made progress in establishing health insurance exchanges under the federal health reform law, Reuters reports.

According to a new HHS report, 14 states -- some of which are led by Republican governors who oppose the overhaul -- either have passed legislation giving them authority to establish the exchanges or already have that power. The other 14 states have used executive orders to prepare for the exchanges or authorized studies on the value of the insurance markets (Morgan, Reuters, 1/18).

Overall, HHS has given $729.5 million in grants for exchange planning, exchange establishment and exchange innovation. Alaska is the only U.S. state that has not received an exchange planning grant. The report notes that more states have applied for establishment grants, which the federal government will award in February (Lee, Modern Healthcare, 1/18).

The administration added that it is prepared to establish exchanges on behalf of states that do not implement their own by 2014 (Alonso-Zaldivar, AP/San Francisco Chronicle, 1/18).

Progress of California's Exchange

California received its HHS grant for health insurance exchange planning in August 2011 (California Healthline, 8/12/11).

In November 2011, California Health Benefit Exchange IT policy adviser Bill Obernesser said the state is in the "highest level" of planning and analysis work in its efforts to meet the Jan. 1, 2014, deadline set by the federal reform law to establish a state-based health insurance exchange.

Over the last several months, the exchange's five-member governing body has been meeting to develop a schedule that would ensure the program is in operation by the federal deadline.

Obernesser said the state has set its own deadline of having the exchange up and running by fall 2013. He added that California's biggest challenge in meeting the deadline will be systems integration (California Healthline, 11/2/11).

Some Say Report Shows Best-Case Scenario

Some observers say the HHS report presents a "rosy outlook" on some states' progress, the AP/San Francisco Chronicle reports. For example, it lists Idaho as a state advancing an exchange, but legislation for approving funding is being blocked by state Republican lawmakers.

Mike Schrimpf, spokesperson for the Republican Governors Association, said, "It seems that the White House is desperate to show progress and is selectively searching for any evidence that states are taking action," adding, "Many of the states that have started action are doing so primarily as a defensive maneuver to keep the federal government from having even greater control over their health care markets" (AP/San Francisco Chronicle, 1/18).