Six states get conditional approval for health insurance exchanges


Six states have received conditional approval to operate online health insurance exchanges, meeting regulatory criteria established under authority of the Patient Protection and Affordable Care Act (PPACA).

Colorado, Connecticut, Massachusetts, Maryland, Oregon and Washington received the go-ahead from the U.S. Department of Health and Human Services to begin enrolling members in October 2013. A total of 14 states have told HHS they plan to operate their own exchanges; the 36 other states have until Friday to decide whether they will create exchanges or default to a federal plan.

Governors in 28 states, including Pennsylvania, New Jersey and Virginia, have decided to have the federal government run their plans.

Many of the governors of those states are Republican; all of the governors of the six states that received conditional approval are Democrat.

Kathleen Sebelius

Despite what more than half of U.S. governors have said about not running their own exchanges, HHS Secretary Kathleen Sebelius wrote in her blog post that she expects to make many announcements in the coming months about states moving forward with their exchanges.

“The majority of states will play an active role operating their exchanges,” Sebelius wrote in the blog post announcing conditional approval of the six states. Read her blog here: Sebelius blog

States have until Friday to announce whether they will run an exchange. The deadline was extended by one month to Dec. 14 to allow states to digest regulations attached to the exchanges, some of which have yet to be announced.

President Obama’s landmark health reform law requires all Americans to be purchase private health insurance or be covered under a government plan beginning in 2014. Those who do not could face fines or have their federal tax refunds withheld until coverage is obtained.

An overlooked portion of the law was made public this week when it was learned that employers will be required to pay an additional $63 per employee in federal fees to cover people with pre-existing conditions. The Obama administration asserts the fee will decrease over time.

About 30 million people are expected to be added to insurance roles when PPACA takes full effect, and about half will likely buy plans through exchanges with government subsidies, and about 11 million more will become eligible for Medicaid.

The Supreme Court ruled in June that states can opt out of the Medicaid expansion portion of PPACA, which was described as being crucial to the law’s successful implementation. Some states asked Sebelius – whose department is writing new regulations related to PPACA – if they could expand Medicaid less than what the Obama administration sought, while still taking advantage of a 90% reimbursement from the federal government.

The Administration said that states will not get full federal support unless they fully comply with the law, requiring Medicaid expansion.

“The Obama administration’s refusal to grant states more flexibility on Medicaid is as disheartening as it is short- sighted,” said Louisiana Gov. Bobby Jindal, chairman of the Republican Governors Association. “The current Medicaid system is broken, and it is an inefficient mechanism for expanding coverage.”

Tom Corbett

Pennsylvania Gov. Tom Corbett said his state will not participate with PPACA because it has not received sufficient support to ensure Pennsylvania could comply with the law.

“For two years my administration has been engaged in careful planning around the implementation of the Affordable Care Act, continually seeking guidance from the federal government,” Corbett said in a statement. “Throughout this time, we’ve asked HHS questions to help determine costs, impacts and flexibility in order to inform our decisions.”

Five days before the deadline for application and submission of blueprints for the exchanges, “we received little acknowledgement of those questions.”

Corbett took Sebelius to task.

“Even HHS Secretary Sebelius recently admitted on a call with governors that the regulations released a few weeks ago were not final and that more drafts are to be expected,” Corbett said.

“Healthcare reform is too important to be achieved through haphazard planning,” he added in announcing his decision to default to a federal exchange. “Pennsylvania taxpayers and businesses deserve…a strong plan that responsibly uses taxpayer dollars.”


13 Responses

  1. edith Says:

    what a huge mess. God help us.

  2. biff Says:

    Interesting that all these states voted heavily for Obama. Plenty of other states have well-running exchanges and they have not been given approval from the benevolent HHS. What a tyrannical government we live under.

  3. Dave Says:

    Here’s where we begin paying for Obama’s re-election. Sadly, the worst is yet to come. God help us !

  4. Gary Says:

    I’m sure the government will get it right this time. After the US Post Ofice & Social Security go bancrupt; Medicare & Medicaide follow; and after the Freddie Mac / Fannie Mae housing debacle I’m confident in giving the government control over my healthcare for sure…aren’t you? God help us is right.

  5. belleboy Says:

    Obamacare is nothing more than a sham and a scam!

  6. gadgonz Says:

    When did 22 out of 50 states become a majority? Look at comment from Sebelius about the majority of the states will have an active role in the managing of their exchange.
    Not to mention 14 have said they will run their own (only 6 have been approved so far; Utah happens to have their own state exchange now, submitted for review and was rejected, yet never told why by HHS).
    And the 8 states who will do joint work, where will the funding and logistical setup come from? If the states could do it on their own, woudln’t they have filed to run their own and not do joint work?

  7. Rick Gary Says:

    the twlight zone continues !

  8. Ross Schriftman, RHU, LUTCF, ACBC, MSAA Says:

    The health exchanges do not provide $1 toward healhcare benefits. They are just another added layer of bureaucracy. They will be responsible for approving plans, collecting premiums, transferring those premiums to the insurance companies, collecting personal income and other information from participants, determining the amount of subsidies and premiums, advising the participants on their plan choices, setting up websites and operations. They will have to provide salaries, benefits and office expenses for their staffs which we will pay for. ALL of these functions are already done by insurance companies and their agents or independent brokers plus the on going service we provide which will not exist in the exchanges.

  9. Dave M Says:

    Holding tax returns until they get required coverage is just wrong ! How this bill passed in the first place is even more wrong ! Note, people in D.C. are EXEMPT from this new law that us working people will suffer from. This kind of health care failed in Canada and they expect it to work in the U.S.? God help us all. Looks like we are all shafted !

  10. Dave M Says:

    I forgot to add, apparently the 28th amendment doesn’t exist anymore or the elected officials in D.C. would also be participating as well. But when asked they ALL said they won’t be included. Hmmm… sounds fishy to me.

  11. Danilo Smith Says:

    We now need Texas to create its health insurance exchanges in support of the Patient Protection and Affordable Care Act (PPACA). ObamaCare could work well for every state if everybody is on board.

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