States and the federal government will be ready to open up new insurance exchanges just a year from now, a top Health and Human Services Department (HHS) official said Thursday.
Gary Cohen, the leader of the federal implementation effort, said exchanges will be operational on Jan. 1, 2014, as called for in President Obama's signature healthcare reform law.
“I am confident that states and the federal government will be ready in 10 months," Cohen said.
Although exchanges don't have to be operational for another year, the enrollment period for insurance plans sold through the exchanges comes earlier.
Exchanges are a massive logistical undertaking. They're intended to function as one-stop shops where consumers can buy insurance, usually with help from a government subsidy. And many Republican governors are refusing to implement state-run exchanges, pushing the task to the federal government.
Cohen said the federal government will be ready to run however many exchanges it needs to. Testifying before the Energy and Commerce Health subcommittee, Cohen said the department doesn't intend to duplicate state functions or usurp the states' traditional regulatory roles in healthcare.
States that don't run their own exchanges now can still take over the task after HHS gets a marketplace up and running, he noted.
“If a state elects to have a federally facilitated exchange at first, it is not a permanent choice,” Cohen said.
Democratic lawmakers dismissed Republicans' complaints about not having enough time or information to operate a state-run exchange.
"That’s flat-out wrong," said Rep. Henry Waxman (D-Calif.). "It seems to me it's just the latest attempt to undo the Affordable Care Act ... let's not buy into this next line of attack that the law must be delayed.”
Dennis Smith, the state health secretary in Wisconsin, said politics didn't stop the state from running its own exchange. Officials there recognized long ago that they couldn't have an exchange up and running by January 2013, when HHS must certify whether states are ready to run their own exchanges.
“We would not have been ready," Smith said. "We took that deadline very seriously.”