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HHS: Twitch by Friday if you'll help build an exchange

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The U.S. Department of Health and Human Services (HHS) is lowering the bar for states that might want to set up their own health insurance exchange programs.

Originally, HHS had asked states that want to build their own exchanges to submit a detailed exchange construction “blueprint” by Nov. 16 — Friday. 

Now, HHS Secretary Kathleen Sebelius has written to governors to tell them that all they have to submit by Friday is a “declaration letter” indicating the state is interested in helping to establish its own “state-based exchange” program, according to a copy of the letter posted by, an affiliate of the National Academy for State Health Policy.

A state can take until Dec. 14 to submit its exchange blueprint, Sebelius said.

A state that wants to work with HHS to develop a “state partnership exchange” — an exchange set up in such a way that a state handles some tasks and HHS handles others — can submit declaration letters and blueprint applications on a rolling basis up until Feb. 15, 2013, Sebelius said.

Sebelius noted that the deadlines are for states that want to have state-based exchanges or partnership exchanges up and running in 2014.

“States will be able to apply to run exchanges in subsequent years,” Sebelius said. “We are committed to providing you with the flexibility, resources, and technical assistance necessary to help you achieve successful implementation of your state’s exchange and look forward to continuing your work with you as we implement the health care law.”

The Patient Protection and Affordable Care Act of 2010 (PPACA) calls for federal and state agencies to set up state-based health insurance exchanges, or Web-based insurance supermarkets, that will sell coverage to individuals and small businesses.

States can choose whether to run their own exchanges, participate in multi-state exchange consortiums, or let the federal government provide exchange services for their residents. States and consortia also can decide whether to oversee all exchange functions or share some responsibility with the federal government. 

HHS posted the final version of the exchange application blueprint, or approval process description, in the summer. HHS applied for Office of Management and Budget clearance for the blueprint in May. 

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