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Lack of state exchange laws squeezes planning effort, officials say
States that didn't create an insurance exchange this year say they're now facing a time crunch that requires them to push the entire process forward at once.
Governors in 10 states have signed laws authorizing an exchange — the new insurance marketplaces created by healthcare reform. By creating the exchange promptly, those states were able to pass difficult policy decisions to the exchanges' boards and give the boards a jump-start on the logistics of setting up a new marketplace.
But policy officials outside of those 10 states say that without a law on the books, they don't have the luxury of breaking exchange planning into multiple phases.
"We do have to do kind of everything at the same time," said Cindi Jones, director of the Virginia Health Reform Initiative.
Although Virginia is among the states challenging the healthcare law in court, Jones said she hopes the state legislature will vote to establish an exchange during its 2012 session.
Linda Sheppard, who leads part of the implementation effort in Kansas, said she's also hoping for a state exchange bill in 2012. If the legislature doesn't establish an exchange, she said, the state might look toward the federal government's offer to divide responsibilities between states and the Health and Human Services Department.
State officials at Wednesday's event also seemed cool to the idea of regional exchanges. The healthcare law authorizes multi-state agreements, which could either combine several states' populations or serve a narrower group of people in multiple states.
Sheppard said analysts had considered a regional exchange with Missouri that would serve the Kansas City metro area, but decided to focus first on the statewide exchange. Officials from Maryland and Washington also said they're not interested — at least for now — in combining their efforts with neighboring states.
