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Feds to run most state exchanges

By Jay MacDonald ·
Tuesday, December 25, 2012
Posted: 10 am ET

Based on widespread nonresponse from states that spent years fighting President Barack Obama's landmark health care reform law, the federal government will be involved in the new health insurance marketplaces called exchanges in more than two-thirds of the 50 states beginning in 2014.

The Obama administration had hoped opposing states would see that it's in their best interest to run their own exchanges as Congress intended after the U.S. Supreme Court upheld most of the Affordable Care Act last summer and the president's re-election effectively ended efforts to repeal Obamacare.

But even after the deadline to submit a plan was extended until Dec. 14, just 18 states and the District of Columbia had come forward to run their own exchanges, according to Kaiser's

States face three exchange options: a state-run exchange; a federal-state partnership exchange; or a federally run exchange. All models are required by law to provide easy-to-use online shopping for affordable health insurance for small businesses and individuals, with open enrollment slated to begin next October.

Last week, Health and Human Services Secretary Kathleen Sebelius gave preliminary approval to Colorado, Connecticut, Maryland, Massachusetts, Oregon and Washington to create and run their own state-based exchanges, and conferred conditional approval upon New York and Kentucky. Other states already on board to run their own show include California, Hawaii, Idaho, Minnesota, Mississippi, Nevada, New Mexico, Rhode Island, Utah and Vermont.

Other states now have until Feb. 15 to sign on for the federal-state partnership option. So far, seven states have partnership plans, including Arkansas, Delaware, Illinois, Iowa, Michigan, North Carolina and West Virginia.

According to media reports, Gary Cohen, who oversees the exchange project as director of the Center for Consumer Information and Insurance Oversight, says work is well under way on a customer service call center, interactive website capable of interfacing with each state's technology system, and a central data services hub that will determine an online applicant's eligibility.

The Congressional Budget Office estimates that 26 million people, including as many as half of the estimated 30 million uninsured Americans, will eventually be insured through the exchanges. Under health care reform, most Americans will be required to obtain health insurance or face a fine beginning in 2014.

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December 27, 2012 at 8:27 am

To realworld & bedoin. Is that the best you can say? Why don’t you give us some facts. You call people names but you don’t explain anything. If Obama didn’t design the Health Care Program so that Companies would eventually switch to Obama Care , why is the penalty a fraction of the cost of a Company’s current heath care cost? Why isn’t the penalty the same a Company’s current cost? It is lower so that they will switch! The ones who are being brainwashed is you (and my relative). Those of us who watch fox news understand that businesses will switch. That was one of our main arguments against it! Of course, maybe I am an idiot. I can switch my employees to Obama Care and save $100,000.00 per year. I have been a saver all of my life. I can afford supplemental health care to protect my family but I’ve been donating to politicians to defeat Obama Care in order to save “your” children. I guess I shouldn’t worry about them.

December 27, 2012 at 8:04 am

Why can our country afford to fund 2 and 3 wars at a time, borrowing to fund them, give huge tax breaks and subsidies to extremely profitable corporations but attempts to provide a uniform healthcare system for all citizens which it is supposed to represent is considered negatively as socialist, fascist and communistic ?? The manipulation of healthcare by insurance companies, corporate healthcare managers, drug manufacturers and "for profit" hospital organizations are closer to removing your "rights" to healthcare than a national program. The last I checked insurance companies, I.E. paid executives, where determining what you could or could not receive from "your" insurance plan, including where and how any disputes where to be arbitrated... Sounds like fascist, communist, marxist system to me... Oh, that's right you DO get to determine which company takes your money until you need the care they determine you will get. And you DO get to stop buying care if you don't like "your" policy benefits. And you DO get to pick another company to buy insurance from.., IF THEY DECIDE to "accept" you and you can afford the price of membership/policy that THEY offer with the terms THEY decide, IF they decide to honor the policy "coverage".. Or you could go to the emergency room and let all of us cover you because of "your right" not to carry insurance or pay the outrageous emergency room costs.. Because you don't want one of those socialist, communist healthcare systems because it's "unamerican" for all of us to have a system where we ALL contribute and assume responsibility for ALL of us... United together for a common cause supporting our fellow citizens equally for the right to have healthy lives, your right how "unamerican" a system is that...!!!!!!

December 27, 2012 at 7:53 am

About 3-4 years ago President Obama, while being interviewed said “It will take a few years, but eventually everyone will be on a single payer program”. It was his words! Just before Christmas, when my wife’s family got together, my democrat relative said that it wasn’t fair that Wal Mart is planning on pushing their workers onto Obama care and I explained how “that was the plan”. I run a business. Ten employees. We pay $1,010.00 per month, per employee ($12,120.00 per year). From my understanding, I can switch my employees onto Obama Care and only pay $2,000.00 per year. I can save $100,000.00per year. While Obama was telling the Country “you can keep your current health care”, he was writing the bill so that every business out there can save thousands to billions of dollars per year. In 2010 AT&T said that their health care cost is $4.7 billion per year, but the cost of switching onto Obama Care will only cost $670,000.00. What do you think will happen? Insurance companies only make 3-5% per year. Who do you think will be picking up the rest of the cost. The taxpayers!!!!!!!!!!!! All of the big businesses will be signing up for Obama Care. People who currently have good health insurance will lose it. If you didn’t already know this, maybe you should ask why the news organization you watch didn’t explain this to you?

December 27, 2012 at 7:46 am

Response to Eotech - You tea party idiots have really been brainwashed. Try listening to something other than fox news,trump and rush limbaugh. By the way - what were the election results again?

December 27, 2012 at 7:43 am

Spot on Eotech. And just so all of you know, HHS, CMS and OPM are running way behind schedule. There is no way all of these exchanges will be in place by October! The average time for the federal government to implement even ONE system takes 3 years. I look to see this crumble State by State.

December 27, 2012 at 7:24 am

Those people who make the argument that they are never sick and therefore should not have to buy health insurance make such a breath-taking short sighted argument. The fact that you live a healthy lifestyle (not smoking, or consuming alcohol and exercising every day) does not mean you can't get sick. In most cases people with cancer and other inherited diseases due to genetics do not initially show symptoms. Preventative care such as annual checkups alone is worth buying affordable health insurance. Even if you are superman or wonder woman and don’t have any ailments. What if you have an accident and break some bones? How will you pay for treatment if you don’t have insurance? That means going to the emergency room and requesting free treatment that all responsible people with insurance have to pay for in higher insurance premiums. People, wake up and break the “penny wise and pound foolish” syndrome!

December 27, 2012 at 6:57 am

When's the last time anyone voting age and above read anything longer than a "tweet". When's the last time anyone read a novel longer than 200pages? Yet the Obamacare bill was over 2500 pages of legal text that I will safely say 99% of America has not read. If people had, many of the electeds now in office across the country would not be in office. If we believe our United States is a "free" country---it requires something more than ranting online. People have fought and given their lives for "their freedom". When's the last time people in your neighborhood attended a local council or a legislative public hearing? When's the last time people read a bill being proposed to become a law? When's the last time people you know picked up the phone and told their elected officials how they felt about a proposed bill and held them accountable as representing them not bowing down to them once they were in office. If you have an opinion about Obamacare---"do" one thing about it---tell your electeds. There are 2700 pages of reasons why these states "opted in" and there are just as many reasons why so many did not. This story doesn't dig deep enough and report those facts. Hopefully, there will be a follow-up article.

December 27, 2012 at 6:09 am

I rarely get sick, almost never enough to go to a hospital.

Should I not get a tax incentive for not burdening the system?

pay less, not nothing, but less, if one is healthy.

I don't have health insurance and have not needed it. Don't smoke, don't drink, no drugs, no religion.

For this I will get a fine? Being healthy should allow me to wave the fine. Does it?

December 27, 2012 at 5:30 am

"Lets look at the facts, Obama wants a single payer system and he will get it."

That is not a fact and your entire rant is based on something that is not a fact.

December 27, 2012 at 5:19 am

Lets look at the facts, Obama wants a single payer system and he will get it. What is a single payer system? Medicare or Medicaid, where the government pays for all your bills. How does the government pay for everyones bills? They don't. The government doesn't pay anyones bills, private citizens and the businesses that employ them do. So, how do you insure everyone and control health care costs while giving the same care you give today? You can't! Anyone with a real education who doesn't have an agenda, like Obama and his regime understadn this major point. To pay for everyones health care you must increase health care fees, you must increase the employers tax burden, you must increase individuals taxes and you must curve the care you can give to the patient. We are mirroring the European/Canadian Health Care System and many educated health care workers who are intimately involved with their systems know they made a huge mistake. They warned us not to go down this path, but Obama's propoganda machine refused to highlight this very important fact. In fact they embarked on a cover up. The government pays medical bills based on DRG's. If you come to the hospital and you are diagnosed they look up the DRG that correlates to the diagnosis and that is the amount the hospital and doctor are paid. My mothers doctor forgave $10,000 because he could; however, when the entire system goes to DRG's doctors are going to have a tough time even paying off their school bills. To become an RN it cost upwards of $50,000 dollars for a two year degree. However, when Obama's health care program goes into full effect there will be less doctors. Nuses are already being asked to get their masters and doctorate degrees to become nurse practitioners to cover for the doctors they lose. Nurses are already over burdened and have too many patients per nurse. California has passed laws to force hospitals to give only so many patients to one nurse, but with every law the costs keep goiing up, more lawsuits are filed and more medical practitioners are leaving a highly litigatous field. Right now, patients with serious illnesses who live in Russia, Canada, and Europe come to America to get immediate treatment. Soon we will be the same as these countries and health care will be rationed out with long lines of patients filling out reams of paper wor that will take months to process. Patients who could have been saved will not, the elderly will no longer be able to get that hip replacement, the quadruple bi-pass because costs must be rationed. Sarah Palins death squads will be a reality, but the media will not expose it to the masses. Soon the elderly who knew, and tasted of a free society will have died off. There memories will be replaced with high powered indoctrination. The young will not know any better because the health care we voted for will be all they know. They will not be able to strive for the American dream, nor will they even know what it is. They will simply work for the government and pay their 60% or more in taxes. They will never taste being an entrepreneur or becoming wealthy. The world will lose when America dies. All the chartible organizations that once received funds from American Capitalistics companies, the wealthy and from the average citizen will all dry up. Charities will be downgraded to what the government can steal from those who work. There will be no incentive to work hard, companies will fail with the heavy regulatios placed upon them by the government of this country and the United Nations. America will fall and the world will suffer the consequences. Americans are being lead by a dictator that I believe will be as bad as the worst socialist, fascist or communist that ever lived.