Two-Thirds of States Not Planning Health Insurance Exchanges

Laura Joszt

The majority of states either aren't ready or do not want to run a health insurance marketplace, with only 18 providing blueprints for their planned exchanges. The federal government will have to set up the remaining 32 exchanges.

The majority of states either aren’t ready or do not want to run a health insurance marketplace as created by the Affordable Care Act. When the deadline to submit applications passed, just 18 states and the District of Columbia had expressed interest, U.S. Health and Human Services (HHS) Secretary Kathleen Sebelius wrote in a blog post.

In states where the government is not participating in creating a marketplace, the federal government is going to step in to set up the health insurance exchange. In August, the federal government was just realizing how involved it would be in the state-based health insurance exchanges. At that time just 13 states had expressed that they were intending to set up the exchanges.

So far, HHS has conditionally approved the blueprints for the District of Columbia, Colorado, Connecticut, Kentucky, Massachusetts, Maryland, New York, Oregon and Washington.

“These states are on track to meet all exchange deadlines and be ready for open enrollment in ten months,” Sebelius wrote.

States whose marketplace blueprints still need to be reviewed are California, Hawaii, Idaho, Minnesota, Mississippi, Nevada, New Mexico, Rhode Islands, Vermont and Utah.

Reuters reported that the number of states participating was in line with expectations, yet back in August, The New York Times reported that the government expected to run exchanges in about half of the states. Now, the federal government will be running exchanges in almost two-thirds of states.

States that haven’t supplied a blueprint for a marketplace have another deadline ahead of them.

“We know that some states will need more time before being ready to run their own marketplace or want to run part but not all of the exchange in 2014,” Sebelius wrote. “These states can choose to enter into a State Partnership Exchange in which the State assumes responsibility for plan management and/or consumer assistance. A partnership exchange allows states to make key decisions and tailor the marketplace to local needs and market conditions. States have until February 15, 2013 to choose a state partnership exchange.”