HHS Gives States One More Month on Exchange Decisions

November 16, 2012 — The Obama administration on Thursday announced that states will have four more weeks to declare whether they intend to run their own health insurance exchanges under the Affordable Care Act (PL 111-148), The Hill's "Healthwatch" reports (Baker, "Healthwatch," The Hill, 11/15).

Under the ACA, states can operate their own exchange, partner with the federal government or let the government run an exchange for them.

In a letter sent to governors last week, HHS Secretary Kathleen Sebelius said the administration was extending the deadline for states to submit detailed applications -- or blueprints -- required by federal officials to Dec. 14, but the Nov. 16 deadline to notify HHS of their decisions would stand.

Meanwhile, states that intend to partner with the government will have until Feb. 15 to submit their declaration letter and blueprint. Sebelius noted that the extended deadlines would not affect the anticipated launch of the exchanges in January 2014 (Women's Health Policy Report, 11/13).

On Thursday, Sebelius said states will be able to inform HHS of their decisions on Dec. 14, when they submit their blueprints for how they would operate their exchanges (Blesch/Daly, Modern Healthcare, 11/15).

The second extension came one day after two Republican governors sent a letter to President Obama asking that the administration postpone the deadline until governors' questions about the exchanges have been answered and the exchange rules have been finalized (Millman, Politico, 11/15).

Sebelius announced the extension in a letter to the governors -- Virginia Gov. Bob McDonnell and Louisiana Gov. Bobby Jindal, who were representing the Republican Governors Association (Modern Healthcare, 11/15). She noted that additional guidance about the exchanges "will be released in the coming days and weeks" (Politico, 11/15).

RGA spokesperson Mike Schrimpf on Thursday said the association "appreciate[s] the administration's acknowledgement that not enough information has been provided to the governors and hope this is a signal that the White House intends to engage directly with the governors on the substantial policy issues that remain unresolved and are open to real reform" (Galewitz, Kaiser Health News, 11/15).

Latest on States' Decisions

As of Thursday evening, 17 states and the District of Columbia have said they will run their own exchanges, five states plan to pursue partnerships with the federal government and 20 states have said they will not operate their own exchanges, according to "Healthwatch."

Meanwhile, eight states -- Arizona, Idaho, New Jersey, Oklahoma, Pennsylvania, Tennessee, West Virginia and Wisconsin -- remained undecided prior to HHS' announcement to extend the deadline (Baker/Viebeck, "Healthwatch," The Hill, 11/15).