Will 16 States Eat PPACA Exchange Construction Dust?

A state can choose whether to handle all or part of the process of setting up and supervising an exchange, or it can turn all responsibility for setting up an exchange over to HHS.

HHS reports that 49 states, the District of Columbia and 4 territories have received initial exchange planning grants.

The new round of exchange construction grant announcements has increased the number of states receiving construction grants to 34, from 26. The District of Columbia also has received an exchange construction grant, officials say.

The 16 states that have received only the initial planning grants, or no grants, are Alaska, Florida, Georgia, Kansas, Louisiana, Montana, New Hampshire, North Dakota, Ohio, Oklahoma, South Carolina, Texas, Utah, Virginia, Wisconsin and Wyoming.

In June, HHS said it will be accepting applications for state exchange construction grants up until 2014.

Regulators from some states in which many officials oppose the idea of participating in PPACA have said staying out of the exchange program could backfire, by maximizing HHS control over a state's local health insurance market. Others have argued that refusing to take the grants is a matter of principle, that the federal government could end up failing to make good on much of the support it has promised to provide for PPACA-related programs, including the exchange system; and that an election victory for Mitt Romney in November could reduce the risk involved with letting HHS be responsible for handling PPACA exchange services.