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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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tom diferdinando
December 27, 2012 at 9:05 am

You folks must be nuts, lose your job get sick you will lose everything you own or try to buy heathcare on your own in your 50's or 60's . Medicare was begun because private insurance companies wouldn't insure older people. Die young and the current system will serve you well. Get old and trust for profit insurance to treat you well. Obamacare was enacted because for profits were shafting everyone they could while paying ceo's huge saleries. The government is far from ideal but for profit insurance companies are organized crime. Put your politics away and think.

December 27, 2012 at 9:00 am

Scott, my boy, it sounds to me that you are anxious to get on the Federal teat........ You need to go live in the UK for awhile to get a taste of what's coming.... get transferred there and the first thing you hear is "watch out for the National Health System..... funded through tax rates. If you make 0 to $35,000, your tax rate is 20%, $35,000 to $150,000 its 40%, above $150,000 and you pay an additional 50%... it doesn't stop there. There is a 20% VAT on most everything you buy and to top it off, if you own a color TV there is an annual $230 license fee and if you only own a black and white TV it's just $80. per year..... but then again you get all that rationed free healtcare. Doctors are paid by the government.... average starting salary around $65K, for general medicine topping out at about $180K.... If you are a specialty surgeon, you could pull down as much as $210K.. and then don't forget you have to pay taxes........

December 27, 2012 at 8:54 am

Eotech - you are just plain wrong and have fallen victim to the right wing misinformation that plagues this country.

I've lived in the UK, Canada and the US. The ridiculous stories that people with dire conditions are going untreated for months are simply not true. The US does not have the best healthcare system in the world, but we do have the most expensive.

Your obstructionist, doomsday views are the reason we can't even move forward on the issues the two sides agree on. Be part of the solution or get out of the way.

December 27, 2012 at 8:53 am

The last line f the article is right from the Obama lying narrative. The federal government has no ability to levy 'fines' for inactivity. The Supreme Court said it was a "TAX". But the lie is continued by the media. So much for truth in journalism.

The Obama 'promise' to not raise taxes on the middle class, now broken once, will be broken again and again over the next four years.

December 27, 2012 at 8:53 am

The idea of “good” health care for everyone is a nice idea, but that is just what it is. A nice idea. Everyone is concentrating on the 15% that don’t have health care and forgetting about the 85% that will lose their current program under Obama Care. There are better ways to help the 15% without destroying it for the 85%. Once businesses switch to Obama Care and the system is overwhelmed, instead of 15% not getting preventative care, 100% of some segments of our Country won’t get it. My wife had breast cancer at 44. A mammogram caught it. She’s fine. In 2010 the government’s recommendation came out that mammograms don’t need to start until age 50. My wife would have been dead. When Obama Care is overwhelmed, the first thing that will be trimmed are these “early” preventative tests which don’t catch much disease. Then 100% of that group will lose their preventative care. While 1 in 8 women get breast cancer, the odds of getting it in your 40’s is a lot lower.

December 27, 2012 at 8:50 am

Right on Eotech!
The last thing most people want to hear is "We're from the Government, and we're here to help". The recipient culture of the UNINTENDED consequences of Government programs such as Welfare, and it's off-shoot programs, the under-educated, under-employed, under-motivated, and the too-young-to-know-the difference, are the same who carried the vote for our new socialist form of government. "We the Sheep" not "We the People", are being led to slaughter.
I thought I knew better, when my parents tried to spare me some of life's lessons, I opted to learn the hard way. It is a generational thing. Just as I frustrated my parents, it is frustrating now, to watch our nation have to re-learn the lessons from communism, and other failed socialist concepts. The original Tea Party was once a group of heros back in the day, and surely the Queen didn't see it that way. Here we go again.

December 27, 2012 at 8:48 am

Resp to jimbo070

The political posturing imposed by the States with regard to opting out of creating a state run exchange was & is intended to stop the system from moving forward.
If the state run exchange is put into place it levies taxes against every business in the state in order to pay for the exchange.
If the Fed's impose the exchange, there is currently no language in the law that allows for the same taxes to be implemented nor is there language in the law to fund the federal based exchange.
This is going to be the cause for more debate on the House floor which is currently a Republican majority which will hopefully stall the implementation of the federal exchange & allow for further scrutenty of the "approved" program.

It doesn't hasten the push toward socialized medicine.
As you should already know, deadlines are meaningless in Washington. If after further examination the states wanted to re-investigate the state run exchange, the fed's probably wouldn't object. After all... the voting public gave the President a pass for 4 years of no approved federal budet & accrual of more federal debt than all other President's in US history. (& He can't blame that one on Bush.)

December 27, 2012 at 8:37 am

If you want to know what level of healthcare this system will become, just take a look at the VA. If anyone has ever had to be in a VA facility outside of Washington DC they should be shaking in their shoes that this new system is going into place. It's not if, but when the system becomes a shell of it's former glory. Telling the American People that it's because the uninsured could not get affordable healthcare is a lie. But hey, it's our government at work here. In every case where the government has taken over or tried to do something that was already working in the private sector it has been a failure. This will be no different. What we are about to see is a mass exodus of practicioners & healthcare workers leaving the medical field because of lack of pay & unresonable work loads.
The idiots in Washington who are putting these mandates in place have never had to do anything outside of government & most of the President's staff (including the President) have never done anything meaningfull in the private sector. They are not qualified to govern themselves, much less tell me how to best spend my money or tell me how to get healthcare.
This is going to be one big shafting at the cost of the taxpayers.
But hey, the non-taxpayers & welfare recipients that got the Dem's re-elected don't care because they won't pay for anything anyway.

December 27, 2012 at 8:36 am

Feds have no problem with the states turning down the management of the system. This response is just hastens their goal....... socialized medicine.. this is not going to be good...

December 27, 2012 at 8:33 am

Scott, your comment is spot on, PURE GENIUS! I could not have articulated those thoughts clearer. I’m sometimes baffled by some of the mindless baseless rants of people with agendas that in most cases do not serve us well. These people have a way of convincing the most vulnerable of us to consistently vote against their best interests.