Health Insurance Exchange Decision Deadline Approaching

Posted on: November 6th, 2012 by SamTabes No Comments

UPDATE 12/19/2012 – The deadline date in regards to this previous blog entry was extended to December 14th, and as of that time 18 states have decided to set up their own health insurance exchange for purchasing health insurance policies.  The remaining states still have time to determine whether they will be using the federal health insurance exchange which is still in the works.

November 16, 2012 is the date states must decide whether they will set up their own health insurance exchange or participate in the federal health insurance program.  States will be required to notify the federal government of their decision regardless of how they feel about this provision in the Affordable Care Act.  Out of the 50 states, only 15 along with the District of Columbia have started the process of setting up their exchange.  Exchanges will be the marketplace for millions of Americans to shop for health insurance and they are supposed to be fully operational by January 1, 2014.

There is a lot of debate out there about the validity and effectiveness of exchanges, but the law is in place despite the opposition.  States that choose not to build their own exchanges will default into the program designed by the federal government.  Experts believe that many states that want to operate their own exchange may not have the time to get them fully in place by 2014.  The government may end up putting exchanges in place for over 30 states according to Chris Vest’s article on

Time will tell if states can get it together in time to develop quality health insurance exchanges.  Many states waited until the Supreme Court’s ruling was made over the summer setting them up to scramble for last minute decisions.  In addition to this, states have received little guidance from the federal government on how to set up the exchange.  The Department of Health and Human Services (HHS) set up an outline with 10 important benefits that must be included in their plan.  These will be the minimum standards required in the exchanges.  Some of the basics include coverage of ambulance services, ER services, and prescription drug coverage.

Cheryl Smith, a director of Leavitt Partners, says the biggest problems for states are the overabundance of information and lack of guidance from the HHS.  Many states still are unsure what their exchange is going to look like, nor are they sure what benefits will be included.  Government officials say the law recognizes that states have varying needs based on demographics and leeway is given based on individual states’ needs.

The HHS Spokesperson, Erin Shields Britts, points out that over the past two years the HHS has been in continuous contact with the states trying to answer all questions and clear up any confusion.  They are working on bulletins, phone calls, webinars, meetings and rulemaking to keep states informed.  There are a handful of states taking advantage of all of this information and working with the government to ensure the exchanges are operating in a timely matter.  It’s a race against time to determine if they will end up making the deadline for their important health insurance exchange decision.

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