Health Insurance Exchanges and Deadlines Under the ACA: Part 2 of 2: What are the deadlines now?

November 29, 2012

Health insurance exchangesThis article continues from the end of Part 1 of an article previously posted here on the subject of Health Insurance Exchanges and Deadlines under the Affordable Care Act.

In a letter on Thursday, November 19, 2012, the Secretary of HHS extended deadlines for a second time.  Secretary Kathleen Sebelius granted a group of Republican Governors’ requested extension of certain deadlines established by the Affordable Care Act.  The deadlines concern implementation of Health Insurance Exchanges.  Robert Pear, “U.S. Extends Deadline for States on Health Insurance Exchanges” (New York Times).  Agreeing to this request seemingly places the Secretary in a bind to review all the materials submitted by the States in two weeks or less.  The deadlines now in effect include:

December 14, 2012:  This is the currently extended deadline for States to notify the HHS of their choice to run their own Exchange (in a ‘letter of intent’) and to submit applications, or blueprints to HHS.

January 1, 2013:  This is the original HHS deadline to approve or to conditionally approve State-based Exchanges.  This deadline has not been changed as of this writing.  By January 1, 2013 the HHS Secretary must review submitted Blueprints for a demonstration by the State of its “operational readiness to execute Exchange activities….   Conditional Approval will be granted for State-based Exchanges and Partnership Exchanges that do not meet all Exchange Approval requirements on January 1, 2013, but are making significant progress toward these requirements and will be operationally ready for the initial open enrollment period beginning October 1, 2013.”  Blueprint for Approval of Affordable State-based and State Partnership Insurance Exchanges, August 14, 2012.  If HHS gives Conditional Approval of a State-based Exchange, then State control will extend over the features approved by the HHS, while the HHS will administer the remainder.

February 15, 2013:  This is the extended deadline for States which “want to run exchanges in partnership with the federal government … to file applications” with HHS.  Robert Pear, “U.S. Extends a Deadline for States on Coverage” (New York Times).

October 1, 2013:  Initial open enrollment period begins on October 1, 2013.  The initial open enrollment period runs through March 31, 2014.

December 15, 2013:  The Exchange must ensure an initial effective date of  Coverage of January 1, 2014, by December 15, 2013.

As soon as deadlines established by the Affordable Care Act for implementing Health Insurance are reached, they are extended, it seems.   It is certain, however, that  there will come a time when States must decide, one way or another, among the three available choices:  (1) a State-based Exchange, (2) a State Partnership Exchange, or (3) a Federally-facilitated Exchange, which is not really a State Exchange at all.   Last year, the Congressional Budget Office estimated that 25 Million people will obtain Health Coverage using these new online shopping malls.  Although this estimate may be outdated now, there is no question that whatever choice a State makes will affect the Health Insurance Coverage choices which must be made by millions of people in theUnited States.