The U.S. Department of Health and Human Services
announced today it had conditionally approved eight new states’ blueprints for health insurance exchanges, making a total of 19 states (and the District of Columbia) that are ready to operate exchanges in compliance with the Affordable Care Act.
And though the February 15 deadline for State-Based Exchange applications looms, there may still be more. During the press call announcing the approvals, an HHS spokesman studiously avoided giving a timetable for the federal government to step in and institute its own exchanges in states that were unready – suggesting that the agency would try to woo a few more into compliance before doing so.
HHS Secretary Kathleen Sebelius opened the call by announcing the new conditionally-approved states: California, Hawaii, Idaho, Nevada, New Mexico, Vermont and Utah received the yellow light for state-based exchanges, and Arkansas was conditionally approved to operate a state partnership exchange, in which the feds work with states to run exchanges -- a sort of hybrid option between running one's own exchange and letting the feds do everything. (Among the other exchange-ready states, only Delaware has been conditionally approved for a partnership exchange.)
The Secretary also announced new guidance on state partnership exchanges, which may be found
here.
Sebelius further announced that HHS was “not approving or denying” an application by the state of Mississippi, due to an “ongoing disagreement among state authorities,” evidently referring to the
battle between the state insurance commissioner Mike Chaney, who submitted a state plan, and Governor Phil Bryant, who wants the feds to do it.
As has been her tendency in discussing these matters, Sebelius emphasized a spirit of cooperation with state governments on exchanges, saying HHS “will work closely with governors who want to shape their states’ participation” in the program.
Some of the states already have exchanges, but need to bring them into line with the ACA and with federal regulations before HHS will accept them. For example, the HHS spokesman, Gary Cohen, director of the Center for Consumer Information and Insurance Oversight, mentioned that Utah's current exchange,
Avenue H, at present serves the small business market but not individuals. “They need to expand their coverage to comply,” he said, and the state “has given us a plan to do that.” He also said that for all the new states “there’s more work to be done” before the conditional acceptance will be finalized.
When asked by a reporter if the states’ plans are “likely” to be finalized, Cohen would only say, “there’s been progress.”