States have until Feb. 15 to say whether they intend to seek a federal partnership exchange.
Only 15 U.S. states plan to operate health insurance exchanges under President Barack Obama’s reform law, leaving Washington with the daunting prospect of creating and operating the new online marketplaces in at least two-thirds of the country, Newsday reports.
On the eve of a federal deadline for states to say whether they will run their own exchanges, 11 other states have informed the administration that it should plan to be heavily involved in setting up private health insurance markets within their borders, said Gary Cohen, director of the Center for Consumer Information and Insurance Oversight, on Thursday.
Experts say the number of states planning to operate their own exchanges could reach 18 and the District of Columbia by the time the deadline expires on Friday. But the administration would still be left to set up exchanges in at least 30 states, a challenge that is raising questions about how successfully U.S. officials can implement a key provision of the healthcare reform law known to advocates and opponents alike as “Obamacare”.
But the Obama administration insists that exchanges will be operating in all 50 states and the District of Columbia as required by the law.
States that don’t run their own exchanges would opt for one of two alternatives: a federally facilitated exchange that requires minimal state participation, and a federal partnership exchange in which states help by performing certain duties.
States have until Feb. 15 to say whether they intend to seek a federal partnership exchange. Four have done so already, Cohen said.
The Patient Protection and Affordable Care Act, which Obama signed into law more than 2 1/2 years ago, is expected to extend health coverage to more than 30 million uninsured Americans after it comes fully into force on Jan. 1, 2014.