States seeking to operate a State-based Exchange or electing to participate in a State Partnership Exchange must submit a complete Exchange Blueprint no later than 30 business days prior to the required approval date of January 1 (November 16, 2012, for plan year 2014)… So says the Department of Health and Human Services.
If you really want to see what is involved in all this and how complex and massive the bureaucracy is, check out this Guidance issued by HHS.
As the Wall Street Journal reported on July 31, 2012
“The exchanges do not merely subsidize but must verify who is eligible by income and residency, police compliance with the individual mandate and report scofflaws to the Internal Revenue Service; regulate insurers and enforce price controls; and penalize businesses that don’t insure their employees. All this is a vast, complex, extremely technical and expensive undertaking that the states can barely handle, even if they wanted to.
To gauge the scale, consider that the IRS inspector general recently reported that ObamaCare “represents the largest set of tax law changes in more than 20 years and affects millions of taxpayers.” The IRS needs to hire 1,278 people this year and another 859 in 2013 to usher in the revolution. For comparison, there are only 6,750 U.S. companies that employ more than 2,000 workers.”
There is one other thing the exchanges must do, that is to collect the fees for adverse selection reinsurance that will be assessed on all group health plans, both insured and self-insured. This means more costs for your employer and you.
As of September 27 only fifteen states have decided to set up their own exchanges, two have elected a state/federal partnership and the balance have done nothing, decided to not set up an exchange or are still studying the matter. Check out the actions by each state here.
To make matters worse there is a point of view that the Affordable Care Act never intended to provide subsidies to those insured through a federally run exchange. A literal reading seems to support that position even though the IRS has ruled otherwise. At least one state lawsuit is challenging that ruling and the Affordable Care Act may be headed for the Supreme Court once again.
We are a mere fifteen months from the date fifty health insurance exchanges must be up and running serving 35 million people or so… can’t wait.
Related articles
- Pa. health insurance exchange plan stalls (triblive.com)
- South Dakota Will Not Run its Own Health Insurance Exchange (insurancejournal.com)
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