State of the States: Health Insurance Exchanges

October 19, 2012

With 27 days until the November 16 deadline for states to declare their exchange plans to HHS, we continue to wait to see how or if states will approach exchanges. This week, Utah and North Carolina offered insights into their exchange options, but first we start in Colorado.  

Last week in Colorado, Governor John Hickenlooper (D) sent a letter to HHS stating his intent for Colorado to operate a state-based exchange. In addition to naming the Exchange’s Executive Director Patty Fontneau as the point of contact for any interaction with CCIIO, the letter also stated that Colorado will be relying on the federal government to administer the exchange’s reinsurance and risk adjustment programs during its first year of operation.  

Also last week, CMS awarded A. Reddix & Associates (ARDX) a multi-million dollar contract to develop training and guidance materials for individuals and organizations that will interface with exchanges, including “insurance issuers, agents, brokers, Pharmacy Benefit Managers, Third Party Administrators, and State Reinsurance Vendors.” ARDX will develop manuals and other training materials in addition to hosting a variety of in-person and virtual training sessions. The project is expected to run through September 2014. 

Checking in with some of the other states, North Carolina officials are now nearly certain that they will not have a state-based exchange by the 2014 HHS deadline. According to Kerry Hall, director of public information with the state Department of Insurance, "People have come to understand there is no time to set up a state-based exchange before the deadline." As for the state’s current plans, state agencies are working with the federal government to establish roles as the state prepares for a federal exchange. According to Julie Henry, a Department of Health and Human Services (DHHS) spokesperson, "DHHS is working with the Department of Insurance to investigate what we'll need to do. It's a conversation right now with our federal partners." It remains unclear whether North Carolina will have a federally facilitated exchange or pursue a federal-state partnership.

According to an article in the Salt Lake Tribune, Utah lawmakers are still undecided whether they will update the state’s current health insurance exchange, “Avenue H, " to comply with the ACA. Ally Isom, a spokesperson for Governor Gary Herbert (R) told the paper that Utah does not “anticipate having a final decision until mid-November, and possibly even later." Also of note, Rep. James Dunnigan (R), Chairman of the Health System Reform Task Force, told The Tribune that he has heard that HHS might move the Blueprint deadline back to December 1. However, it’s still unconfirmed. As he told reporters, "we’re still verifying that."  

In Vermont, the Vermont Chamber of Commerce announced that it is launching a new insurance exchange, Chamber Preferred, for Chamber members to use beginning January 1, 2013. According to Betsy Bishop, president of the Vermont Chamber of Commerce, the Chamber decided to launch the exchange after many Chamber members expressed concern over the creation of Vermont’s state-based SHOP. Plans call for the Chamber’s exchange to offer a wide range of insurance options including: “life, disability, accident, critical illness, long-term care, dental, vision insurance and more, as well as health savings accounts and telemedicine services. Health insurance will be offered to the extent Vermont law allows.” It is unclear how the Chamber’s new exchange will fit into Vermont’s broader exchange plans. Beginning January 1, 2014, all companies in Vermont with 50 or fewer employees will be required to purchase insurance through the state-created SHOP.

Finally, yesterday afternoon the New Jersey Assembly voted 44 to 33 to pass health insurance exchange legislation, A-3186. Identical legislation was approved in the Senate on October 4. The bill now heads to Governor Chris Christie (R) who has said he will not act on the legislation until after the November 6 elections. Earlier this year in May, Governor Christie vetoed similar legislation because he believed it was premature to enact legislation before the Supreme Court ruled on the constitutionality of the ACA. 

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