The state-based health insurance exchanges are a big part of the president’s health care law, and the federal government is finding itself a lot more involved in them than initially expected.
According to The New York Times, many states won’t have any insurance exchanges set up in time for 2014 — the year all Americans need to have insurance or pay the penalty — partly because Republicans in some states are resisting creating them and partly because the task is so complex and exhaustive.
So what’s the government to do when a federal law requires citizens do something but their states aren’t offering it? The federal government is stepping up to set up and run federal exchanges.
Michael Hash, the top federal insurance regulator, told the Times that these federally facilitated exchanges in states that won’t be ready in time will be live in October 2013, when open enrollment starts.
Just 13 states have written to President Obama that they are intending to set up exchanges, according to the Times. But the federal government is expected to run the exchanges in about half of the states, which is not what had been intended when Congress passed the bill two years ago. According to the Times, the government is looking at a tricky situation:
“In running an exchange, federal officials face a delicate political task. They will encourage people to enroll, promoting the exchange as an important part of Mr. Obama’s health care overhaul. But they do not want to feed fears of a federal takeover or alienate state officials whose help they need.”
When the exchanges go live, consumers will have to see for themselves if there’s any difference between the federal-run exchanges and the state-run ones.