State health care exchange plans still must be in place for approval by Jan. 1, 2013, but the U.S. Department of Health and Human Services (HHS) will help support the process operationally as states move toward exchange certification, according to Amanda Cowley, acting director for state health exchanges at the department's Centers for Medicare & Medicaid Services (CMS).
"States have made some progress," Cowley told participants at America's Health Insurance Plans state issues conference in Washington Thursday. "States are a lot smarter now than they were a year ago. Over 80% of states have done background research."
The extent to which states have started to act varies widely, but HHS is "seeing a movement and is very pleased with that," Cowley said.
HHS is trying to "intensify" its response to the states, and has been holding listening sessions and "imagining a highly collaborative" process.
A proposed HHS rule allows for conditional approval of a state exchange if the state is advanced in its preparation but cannot demonstrate complete readiness by the January 2013 deadline. The proposed rule also allows states that are not ready for 2014 to apply to operate the exchange for 2015 or any subsequent year. HHS will continue working with states to support their progress.
According to a source, HHS is may be hiring another 150 people just to work on exchanges.
If a state does none of these things or rejects the creation of a state health care exchange, those that would be insured default to a federal exchange in the PPACA.
