WASHINGTON (AP) — The Obama administration Thursday cleared four Republican-led states to build their own health insurance exchanges.
With open enrollment for millions of uninsured Americans just nine months away — Oct. 1, 2013 — the four GOP-led states became part of a group totaling 17 states plus Washington, D.C., that have gotten an initial go-ahead to build and run insurance exchanges. Seven were approved Thursday.
Significantly, the list also included California, which has nearly 7.5 million uninsured residents, more than any other state. Democratic-led California was an early supporter of the Patient Protection and Affordable Care Act of 2010 (PPACA) and had been working diligently on its plan.
Officials at the U.S. Department of Health and Human Services (HHS) expect about 8 in 10 exchange users to be eligible for income-based federal help with paying their premiums.
Small businesses will have separate access to their own exchanges.
The HHS exchange approvals announced Thursday are provisional; administration officials said more work remains to be done before they'll issue final sign-offs.
The GOP-led states conditionally approved are Idaho, Nevada, New Mexico, and Utah.
Idaho and Utah have Republican governors and legislatures.
Nevada and New Mexico have GOP governors, but Democrats control their legislatures.
"We're on track for Idaho having a say over how this process works, instead of having the federal government dictate all of it," said Jon Hanian, spokesman for Republican Gov. C.L. "Butch" Otter. The legislature still has to weigh in.
A fifth Republican-led state, Mississippi, may yet win approval. However, the administration's decision is complicated by a legal dispute between Republican state officials. The governor does not want to participate; the insurance commissioner does.
The federal government will set up and run the new marketplaces in states that opt out of playing any role, and 19 Republican-led states have taken that route.
