Governors grappling with the best way to set up a marketplace of insurance plans under President Obama's health care reforms will have another month to develop their strategies, after Virginia Gov. Bob McDonnell and other conservatives called on the federal government to provide harried states more information before an implementation deadline for the controversial law.
Health and Human Services Secretary Kathleen Sebelius sent a letter to Republican governors that extends the deadline — initially set for Friday — to Dec. 14 for states to declare how they plan to set up state-based health exchanges mandated by the Affordable Care Act.
Under the president's reforms, the health exchanges are supposed to be operation-ready by October 2013 so they can be activated at the start of 2014. States can set up their own exchanges, enter a partnership with the federal government or have the federal government set one up for the state. Those that opt for a partnership have until Feb. 15 to submit their intentions and applications, according to the HHS.
As of Friday, 13 states were still deciding whether to set up their own exchange, according to state-by-state tracker from the Kaiser Family Foundation.
The extension gives time to states that were banking on the Supreme Court to overturn the law in June or waiting to see if Republican presidential candidate Mitt Romney would win the White House and roll back the reforms. More recently, states complained they have not received enough information from the federal government to make an informed decision on whether to set up an exchange on their own.
Mr. McDonnell said earlier this month he will allow the federal government to set up an exchange in Virginia. Meanwhile, the state's heavily Democratic neighbors, the District and Maryland, are among places that supported Mr. Obama's reforms from the start.
D.C. Mayor Vincent C. Gray sent a letter to federal government on Thursday that declares the city, with "great pride," is well on its way to setting up its own exchange. The District also submitted a "blueprint" on how it will implement Mr. Obama's reforms.
Meanwhile, the Republican Governors Association was busy drafting a request for more time to sift through their health exchange options. In a letter to Mr. Obama, they said the existing time line was "unworkable" in light of the health care law's "enormous strain on state governments and budgets."
"States are struggling with many unanswered questions and are not able to make comprehensive far-reaching decisions prudently," they said in the letter, which also congratulated Mr. Obama on his "impressive victory" in the election. "In the past months, we have sent letters with many specific questions to help us make an informed choice, and our letters have been generally ignored."
Ms. Sebelius responded to their complaints in her letter late Thursday to Govs. McDonnell and Bobby Jindal of Louisiana, writing that the federal government will "do everything possible to answer questions and provide technical assistance to state leaders."
Jon Gruber, an MIT professor who helped to craft health care reforms in Massachusetts before advising the Obama administration on its law, told The Washington Times this month that the situation "comes down to the ability of the federal government to help these states across the finish line."
The hard part of the health care reforms will not be these initial policy decisions, he said. Rather, the toughest task will be setting eligibility requirements "like deciding which insurance plans should and should not be included."
"States have plenty of time to do the latter," he said, "if they let the feds help with the former."
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