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Many States Say 'No' to Health Insurance Exchanges
Date:12/18/2012

By Karen Pallarito
HealthDay Reporter

TUESDAY, Dec. 18 (HealthDay News) -- Half of the states in the nation have rebuffed a key provision of the Obama administration's health reform law: the creation of state-based health insurance exchanges, according to data compiled by the Henry J. Kaiser Family Foundation.

States had until Friday, Dec. 14, to submit blueprints for creating their state-based insurance exchanges.

By default, the federal government will implement health insurance exchanges in the 25 states that are not moving forward, helping the uninsured gain coverage. Another seven states, according to the Kaiser Foundation's count, will operate exchanges in federal-state partnerships. These arrangements will allow states to share the administrative burden of exchange implementation with the federal government.

"I'm sure it's a disappointment because the overall hope and plan from the beginning was to have as many states as possible to go ahead and implement their own exchanges," said Frank McArdle, an independent health policy and benefits consultant in Bethesda, Md.

On Monday, U.S. Health and Human Services Secretary Kathleen Sebelius said in a blog posting that the federal government had received 10 state applications to run an exchange. Last week, the federal government granted conditional approval of insurance exchanges in another eight states and the District of Columbia, where significant progress has been made in setting up those health insurance marketplaces. In all, 18 states and the District of Columbia intend to run their own exchanges.

"We're looking forward to Jan. 1, 2014, when consumers and small businesses will be enrolled through the exchanges in private health insurance plans and millions more Americans will have the coverage they need and deserve," Sebelius wrote.

State-based health insurance exchanges are a key element of the Patient Protection and Affordable Ca
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