This week saw the gathering of representatives from 46 states and the District of Columbia at a hotel in Virginia. Representatives met with officials from the Department of Health and Human Services and the Centers for Medicare and Medicaid Services to discuss the topic of health insurance exchanges. While many states have shown support for the concept of insurance exchanges, most have been slow to adopt the system. The problem may lie in the lack of guidance provided by the federal government for a system that is to be established by no later than 2014.
This supposed lack of direction from the government is, essentially, an attempt to allow state governments determine how they want to operate their own insurance exchanges. If states build exchanges in a timely manner, they will have the ability to establish the regulations that govern the new insurance market set up in that state. However, they will not be able to determine who is eligible to receive insurance coverage through the system, as that power rests with the federal government.
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The federal government has released details regarding a partnership model that is meant to offer additional aid to states that have yet to accept the concept of insurance exchanges. Through the partnership, the federal government will provide more oversight and direction toward the establishment of an exchange, but will also take more authority in governing the system.