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GAO: Opening insurance marketplaces by Oct. 1 challenging
Heather Stauffer//June 19, 2013
The reports focus on federal progress toward opening the public marketplaces for individual health insurance in the 34 states that have elected not to run their own exchanges and on federal and state progress toward opening Small Business Health Options Programs marketplaces.
In both cases, the GAO said much progress has been made but much remains to be accomplished within a relatively short amount of time, and “Whether these efforts will assure the timely and smooth implementation of the exchanges by October 2013 cannot yet be determined.”
For the private marketplaces, the GAO said, some interim deadlines have been missed, specifically noting a two-month delay on funding awards for navigators. In 15 of those marketplaces the states are currently responsible to implement specific functions, it said, “many state activities remain to be completed and some were behind schedule.”
“While the missed interim deadlines may not affect implementation, additional missed deadlines closer to the start of enrollment could do so,” GAO said.
For the SHOP marketplaces, the GAO said the nature of the activities that the Centers for Medicare & Medicaid Services and the states will conduct “has not been finalized and may continue to evolve.” It noted that as of May 2, CMS had not granted final approval to any state to operate a state-based exchange or to participate in a partnership exchange.
Of the key activities that states originally were supposed to complete from December through March, the GAO said, about 44 percent were behind schedule. Forty percent of those delays were attributable to CMS actions, including revising the target completion dates, and 60 percent of them were related to state factors.
In both reports, the GAO noted that the U.S. Department of Health and Human Services emphasized its progress and expressed its confidence that exchanges will be open and functioning in every state by Oct. 1.
