States Given Extra Month for Health Exchange Blueprints

President Barack Obama’s administration gave U.S. states one more month to decide how they plan to develop new health exchanges that will let people shop for insurance coverage.

While the states still must say by Nov. 16 if they plan to build their own marketplaces, they can now wait until Dec. 14 to submit the actual blueprint, Health and Human Services Secretary Kathleen Sebelius said in a letter sent yesterday to state governors. States that want to create a partnership with the federal government to manage the exchanges have until Feb. 15 to outline the duties they’ll handle.

All but 13 governors had taken a wait-and-see approach on the exchanges, which are supposed to be running by 2014 as one of the requirements in Obama’s overhaul of the health-care system. Governors who miss the deadline will turn over to the federal government most authority to decide which insurers can sell plans to their state residents.

“The administration is committed to providing significant flexibility for building a marketplace that best meets your state’s needs,” Sebelius said in the letter.

Thirty-four states have accepted at least two grants from the federal government to start planning an exchange, according to Sebelius’s department. That puts about 20 states in a position to build an exchange or partner with the federal government on one, in addition to the 13, plus the District of Columbia, who have already said they’ll run their own.

The federal exchange will also control enrollment of low-income people into state Medicaid programs.

To contact the reporter on this story: Alex Wayne in Washington at

To contact the editor responsible for this story: Reg Gale at

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