States ready for HIX deadline

May 31, 2013 in Medical Technology

The GAO has concluded that the states across the country setting up health insurance exchanges will be ready for enrollment by the Oct. 1, 2013 deadline. Coverage is set to begin Jan. 1, 2014.

The Patient Protection and Affordable Care Act and the Department of Health and Human Services regulations and guidance require states and exchanges to carry out a number of key functions, for which state responsibilities vary by exchange type.

[See also: Survey shows concerns about HIX deadline.]

States can choose to establish and operate an exchange or give the authority to HHS to establish and run  the exchange. States may also choose to enter into a partnership with HHS whereby HHS establishes the exchange and the state assists with operating various functions. Exchanges are online marketplaces – websites – where eligible individuals and small business employers can compare and select health insurance coverage from participating health plans.

According to HHS, 18 states will establish a state-based exchange, while 26 will have a federally facilitated exchange. Seven states will partner with HHS.

In performing its review of state-based excahnges, GAO conducted interviews with state officials in the District of Columbia, Iowa, Minnesota, Nevada, New York, Oregon and Rhode Island. GAO selected these states (GAO refers to the District of Columbia as a state) based on several criteria, such as a three-year average of states’ uninsured population and geographic dispersion.

[See also: States crafting HIX financing.]

A state that chooses to operate its exchange is responsible for:

  • Establishing an operating and governance structure
  • Ensuring exchanges are capable of certifying qualified health plans and making them available to qualified individuals
  • Developing electronic, streamlined, and coordinated eligibility and enrollment systems
  • Conducting consumer outreach and assistance
  • Ensuring the financial sustainability of the exchange
  • A state that partners with HHS may assist HHS with certain functions, such as making qualified health plan recommendations and conducting aspects of consumer outreach and assistance
  • Despite some challenges, the seven selected states in GAO’s review reported they have taken actions to create exchanges, which they expect will be ready for enrollment by the deadline

Of the seven states GAO reviewed, it found:

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Article source: http://www.healthcareitnews.com/news/states-ready-hix-deadline

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