government

Some health insurance exchange work is behind schedule

NEWS IN BRIEF — Posted July 1, 2013

Print  |   Email  |   Respond  |   Reprints  |   Like Facebook  |   Share Twitter  |   Tweet Linkedin

Government entities have made inroads toward establishing federally facilitated health insurance exchanges and marketplaces for small businesses, but additional work lies ahead to get these systems operational by Oct. 1, the Government Accountability Office concluded in two recent reports.

The Centers for Medicare and Medicaid Services has had success in completing certain activities to establish the federally operated exchanges, but many tasks still are unfinished or behind schedule, the GAO stated in one report (link). Federally facilitated exchanges will be run by CMS and are scheduled to operate in 34 states; other states have chosen to operate their own exchanges or partner with the federal government to run the insurance marketplaces.

“The activities remaining cross the core exchange functional areas of eligibility and enrollment, plan management and consumer assistance,” the report stated. The GAO made similar conclusions in a report that focused on Small Business Health Options Programs, or SHOPs, citing development and funding delays that were taking place in one program to provide enrollment assistance and outreach to small employers and their workers (link).

The Dept. of Health and Human Services said it was confident that the new insurance marketplaces would be operational in all states by Oct. 1, when open enrollment begins for consumers. GAO noted that CMS had been working on a data hub to supply consumer eligibility information to state agencies and the exchanges, and was helping states to develop contingency plans for their exchanges.

“Whether these efforts will assure the timely and smooth implementation of the exchanges by October 2013 cannot yet be determined,” the watchdog organization stated.

House and Senate Republicans who requested the report said the findings underscored the Obama administration’s lack of readiness in implementing the Affordable Care Act. “What the GAO found is what most Americans have known all along: This law isn’t ready for prime time, and come October millions of Americans and small businesses are going to be the ones suffering the consequences,” said Sen. Orrin Hatch (R, Utah), the top Republican on the Senate Finance Committee.

On June 24, HHS announced new consumer educational tools such as a 24-hour call center to help individuals prepare to enroll in exchange plans.

Back to top


ADVERTISEMENT

ADVERTISE HERE


Featured
Read story

Confronting bias against obese patients

Medical educators are starting to raise awareness about how weight-related stigma can impair patient-physician communication and the treatment of obesity. Read story


Read story

Goodbye

American Medical News is ceasing publication after 55 years of serving physicians by keeping them informed of their rapidly changing profession. Read story


Read story

Policing medical practice employees after work

Doctors can try to regulate staff actions outside the office, but they must watch what they try to stamp out and how they do it. Read story


Read story

Diabetes prevention: Set on a course for lifestyle change

The YMCA's evidence-based program is helping prediabetic patients eat right, get active and lose weight. Read story


Read story

Medicaid's muddled preventive care picture

The health system reform law promises no-cost coverage of a lengthy list of screenings and other prevention services, but some beneficiaries still might miss out. Read story


Read story

How to get tax breaks for your medical practice

Federal, state and local governments offer doctors incentives because practices are recognized as economic engines. But physicians must know how and where to find them. Read story


Read story

Advance pay ACOs: A down payment on Medicare's future

Accountable care organizations that pay doctors up-front bring practice improvements, but it's unclear yet if program actuaries will see a return on investment. Read story


Read story

Physician liability: Your team, your legal risk

When health care team members drop the ball, it's often doctors who end up in court. How can physicians improve such care and avoid risks? Read story