Health Week Ahead: Insurers Prepare for Exchanges as States Wait

With enrollment in state-run health insurance exchanges set to begin a year from today, 37 governors have yet to formally commit to a project that was mandated by President Barack Obama’s 2010 Affordable Care Act.

America’s Health Insurance Plans, an industry lobbyist that represents Aetna Inc., Humana Inc. and WellPoint Inc., is gathering in Washington this week to talk about the work that needs to be done. States must decide by Nov. 16 whether to build their own exchanges or let the federal government administer all or part the program for them.

Senator Orrin Hatch of Utah is among Republican lawmakers who have complained that the Obama administration hasn’t offered enough information on how any of those options will work, or how they may differ in cost. He chided U.S. Health and Human Services Secretary Kathleen Sebelius last week in a letter about a “lack of transparency” in planning.

“Without specific details provided through the rulemaking process with cost estimates and a clear understanding of the roles and responsibilities of the states and the federal government, states are not in a position to make an informed decision,” wrote Hatch, the Senate Finance Committee’s top Republican.

So far, 13 states and Washington, D.C. have told the federal government they’ll run their own insurance marketplaces.

At the three-day State Issues Conference that starts Wednesday, the health insurers will hear from the Obama administration official in charge of helping states build exchanges, Amanda Cowley. They’ll also hear from state leaders such as Bruce Greenstein, the health and hospitals secretary for Louisiana, which has said it won’t build its own exchange or expand Medicaid to cover more of the working poor.

“There is an urgent need for more regulatory clarity with respect to exchanges and insurance market reforms,” Dan Durham, executive vice president for policy and regulatory affairs at America’s Health Insurance Plans, said in prepared remarks for a Sept. 12 congressional hearing.

Erin Shields Britt, a spokeswoman for Sebelius’s agency, said the administration has been providing the states with information and guidance for the past two years.

“We look forward to continuing our work with states and will provide additional information and guidance as we move forward,” she said in an e-mail.


SEBELIUS SPEECH: Sebelius delivers a speech to the National Hispanic Council on Aging on Wednesday at the National Press Club. The group represents Latino senior citizens and their families, a key demographic for Obama’s re-election effort.

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