The U.S. Department of Health and Human Services (HHS) is starting to get a clearer picture of which states will start their own health insurance exchanges, which will share the job with HHS, and which will do all they can to shun the concept.
Today — November 16 — was supposed to be the deadline for states to submit declarations of their intent to start their own, mostly independent, state-based exchanges.
Earlier this week, HHS said states could get the declaration of intent to HHS by this Friday but take another month to submit a formal exchange program blueprint.
States also have the option of working with HHS to share responsibility for setting up and running an exchange program, or giving HHS full responsibility for providing exchange services for their residents. States will have until February 15, 2013, to apply to work with HHS to run exchanges, Sebelius told RGA leaders in a letter posted on the website of StateReforum.org, an affiliate of the National Academy for State Health Policy.
Washington watchers have been trying to count and classify the exchange notices.
Reporters at The Hill say they have found that 17 states and the District of Columbia want to set up state-based exchanges, five want to set up “partnership” exchanges, and 20 are rejecting the idea of starting exchanges.
Reporters at The Associated Press have counted 17 organizers of state-based exchanges, five organizers of partnership exchanges, and 13 states that will clearly let HHS provide exchange services in their states.
Although many states with Republican governors have decided against setting up exchanges, some states with Republican governors, such as Mississippi and New Mexico, are hoping to set up exchange programs.
The Patient Protection and Affordable Care Act of 2010 (PPACA) calls for states to set up the exchanges, or Web-based health insurance supermarkets, to help individuals and small groups use new federal tax subsidies to buy high-quality, standardized packages of health coverage.
Governors who have rejected the idea of setting up exchange programs have used different types of language to describe and explain their decisions. StateReforum.org has posted many of the notice letters on its site.
Texas Gov. Rick Perry, R, sent a short, curt note rejecting the exchange program option.