Acknowledging that many states are not prepared to meet deadlines, HHS Sec. Sebelius extended health care exchange deadlines twice in the past week so that states now have until December 14 to decide whether to run their own exchanges and February 15 to decide they would prefer to work in partnership with the federal government. Notwithstanding the new decision deadlines, many states announced their intentions this week. Buried in the news about exchanges was the fact that CMS submitted rules for essential health benefits to the Office of Management and Budget, the last place these rules must stop before they can be published.
AT THE AGENCIES
To date, the CMS has paid more than $8.35 billion through the Meaningful Use Program, which refers to the set of CMS standards that govern the use of electronic health records and allows eligible providers and hospitals to earn incentive payments if they meet certain criteria.
CMS submitted essential health benefit rules to the Office of Management and Budget (OMB) on Thursday, November 8. These rules will outline the specific coverage requirements for insurance plans operating in the health insurance exchanges. Once the rules are reviewed by the OMB, they can be published.
IN THE STATES
On Wednesday (11/14), Virginia Gov. Bob McDonnell and Louisiana Gov. Bobby Jindal, the current and incoming chairmen of the Republican Governors Association, sent a letter to HHS Secretary Sebelius explaining that governors do not have sufficient information to determine whether they should operate their own insurance exchanges or leave the job to the federal government.
On Thursday (11/15), the federal government gave states another month to decide if they will operate their own insurance exchanges. This was the second time in a week that similar deadlines have been extended. Initially, the deadline for states to decide whether they would have a state, federal or jointly-run exchange was Friday November 16. On Friday (11/9), Sec. Sebelius sent a letterto the states advising them they could submit their blueprints in December instead of November.
On Thursday (11/15), North Carolina Gov. Bev Perdue announced that the federal government and state will share the responsibility for setting up a health care exchange in North Carolina. Gov. Perdue said she would have preferred a state-run exchange but felt that the intermediate path would give the state more future flexibility.
On Thursday (11/15), South Carolina Gov. Nikki Haley wrote to Sec. Sebelius saying that South Carolina “should not and will not set up a state-based health care exchange.” Louisiana Gov. Bobby Jindal and Alabama Gov. Robert Brantley also announced that their states would not set up exchanges.
Incoming Florida State Senator President Don Gaetz and incoming Florida House Speaker Will Weatherford sent a letter on Thursday (11/15) to HHS saying that Florida will miss the November 16 deadline to report whether the state would create its own health insurance exchange or let the federal government set it up for them. The letter explained that the state cannot move forward without more detailed rules on exchanges.
On Thursday (11/15), Nebraska Gov. Dave Heineman also opted to have the federal government handle Nebraska's exchange. Gov. Heineman cited the expense of establishing the state-based exchange as the basis for the state’s decision.
On Wednesday (11/14), Mississippi Insurance Commissioner Mike Chaney reported to Washington that his agency would proceed with a state-run exchange.
Arizona Gov. Jan Brewer announced late Thursday (11/15) that she would postpone her decision on her state's health care exchange given the deadline extension by HHS.
Missouri Gov. Jay Nixon said Thursday (11/8) that his state would not be able to set up a health exchange in the state.
On Tuesday (11/6), Alabama voters passed Amendment 6, which nullifies health care mandates; Montana passed LR-122, which prohibits the state or federal government from mandating the purchase of insurance; and Wyoming passed an amendment to its constitution that guarantees citizens the right to make their own health care decisions as well.
On Tuesday (11/13), Ohio Lieutenant Governor and Director of Ohio’s Department of Insurance Mary Taylor announced they believe it is best for the state to let the federal government run the state’s exchange.
ON THE HILL
The House Ways and Means Committee subpoenaed Secretary Sebelius for more information about the administration’s expenses with respect to promoting the Affordable Care Act. This is the second subpoena House Republicans have sent Sec. Sebelius in the past month.
To view our compilation of recent health care reform implementation news, click here.