Many states not prepared for healthcare law
Tuesday, October 02, 2012
Many states not prepared for healthcare law
By: Sandhya Somashekhar, Washington Post
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.
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 said. 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 exchanges
are a critical piece of the health law, a resource aimed at helping
millions of uninsured Americans find private plans, get government
subsidies or gain access to Medicaid, the state-federal program for
the poor and disabled.
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.
Moreover, many Republican-led states resisted the exchanges in
the hope that the Supreme Court would strike the health law down
this summer, or that Republican presidential candidate Mitt Romney
would win the November election and repeal the law next year.
"We thought states would sit down and weigh the pros and cons of
taking on this responsibility," said Alan Weil, executive director
of the National Academy of State Health Policy. Instead, "states
are looking at this much more from a partisan lens and less through
a strategic analysis of running an exchange."
Some experts believe a larger number of states will eventually
set up their own exchanges if President Obama is reelected. Their
timetable is short, however, because the exchanges must be
operating in time for open enrollment in October 2013.
States must declare their plans to the Department of Health and
Human Services by Nov. 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.
"We have worked closely with states to give them the flexibility
they need to establish an exchange, and no matter what course
states choose, consumers in every state will have access to an
[exchange]," said Erin Shields Britt, a spokeswoman for HHS.