With first open enrollment season behind them, states move ahead -- though slowly

Apr 29 2014

Marketplace reports on the lessons learned by states operating their own online health insurance exchanges and how these experiences will affect the year ahead. In related news, the Colorado exchange reports that it's on track to meet its goal for this year while New York health officials say they will not require out-of-network coverage on next year's Affordable Care Act plans.

Marketplace: State Exchanges Going Into Year Two, But Slowly
At one point, Affordable Care Act architects thought every state would eventually run its own exchange. So far only about a quarter of states -- and the District of Columbia -- have actually done it. Or at least, they have tried their best to. Oregon's exchange voted to have Washington run the IT side of the operation on Friday. That's after the state received some $300 million in federal funds to get its own of the ground. There are lots of reasons why states may want to take over their exchanges from the feds sometime in the future. But here are six reasons why they may not be in such a hurry: "Hawaii, Maryland, Massachusetts, Minnesota, Oregon and Vermont," says Caroline Pearson who tracks state exchanges for consulting firm Avalere Health (Gorenstein, 4/25).

The Associated Press:  Exchange CEO: 128K Signed Up For Private Insurance
The CEO of Colorado's health-insurance exchange say it's on track to meet enrollment goals for this year. Patty Fontneau told state lawmakers Thursday that 128,000 people have signed up for private health insurance since the fall. Another 178,000 people signed up for government-run Medicaid coverage. However, she didn't know how many of the people who got insurance were previously uninsured. Federal regulations don't require people to report that but half of exchange customers who did answer the question said they didn't have insurance before (4/25).

The New York Times: New York Will Keep Affordable Care Act Health Plans Restricted
New York State health officials said on Friday that they would not require out-of-network coverage on Affordable Care Act health plans next year, a decision likely to disappoint customers who have complained that they can no longer use their favorite doctors and hospitals. Restricting consumers to a fixed network of doctors and hospitals, called in-network coverage, helps keep costs down, and for the first year, none of the 16 insurance companies in New York's exchange deviated from that model (Hartocollis, 4/25).

Also in the news --

Modern Healthcare:  CMS Moving To Neutralize State Control Over Exchange Navigators
The CMS wants to tighten the rules for navigators -- those who assist people in signing up for insurance on various state and federal exchanges. Its proposed rule would pre-empt recent state efforts to regulate, and some would say hobble, navigators. Stakeholders commenting on the proposal raised concerns about whether the CMS is overstepping its authority in the matter (Dickson, 4/25).