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HHS likely to extend exchange deadline

Handful of Republican governors balk at exchanges

Topics: Medicaid, Reimbursement, Finance

November 09, 2012

HHS is expected to extend the Nov. 16 deadline for states to declare whether they will run their own health insurance exchange, partner with the federal government, or allow the federal government to do it for them, according to several state officials, CQ HealthBeat reports.

According to CQ HealthBeat, HHS likely will set a new deadline for states that intend to create their own exchanges, and a rolling deadline for states interested in partnering with the federal government.

State decisions

A number of governors this week announced they would not create an exchange, meaning that the federal government will do so. 

  • Kansas Gov. Sam Brownback (R) on Wednesday said the cost to his state of setting an exchange would be prohibitive. In a statement, Brownback said, "My administration will not partner with the federal government to create a state-federal partnership insurance exchange because we will not benefit from it and implementing it could cost Kansas taxpayers millions of dollars."
  • Missouri Gov. Jay Nixon (D) also announced his state will allow the federal government to build the exchange, saying, "The only option for Missouri at this time is to indicate that we will be unable to proceed with a state-based exchange absent a change in circumstances." Nixon previously said he would like Missouri to run its own exchange, but voters on Tuesday approved a ballot measure prohibiting the governor from establishing a state-run exchange without legislative approval. The state Legislature does not return to session until January. 
  • Virginia Gov. Bob McDonnell (R) on Wednesday said the state would not build an exchange, citing a lack of federal guidance to make a decision before the deadline. "At this point, without further information, the only logical decision for us is to use the federal option," McDonnell said.

The announcements come after Florida Gov. Rick Scott (R) confirmed earlier this week that his state would not create its own exchange or partner with the federal government. In addition, Georgia Gov. Nathan Deal (D) on Wednesday hinted that his state would not implement its own insurance exchange, citing federal regulations that would restrict Georgia's ability to design its own program.

Avalere Health earlier this week estimated that more than one-third of states likely will defer to the federal government to operate an exchange for them and 13 states likely will partner with the federal government (Norman/Millman, Politico, 11/8; Lieb, AP/San Francisco Chronicle, 11/8; Gordon, Kansas City Public Media, 11/8; AP/Modern Healthcare, 11/8; Adams, CQ HealthBeat, 11/8).

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