Update on Health Insurance Exchanges: State Strategies, Progress Vary

Under the Patient Protection and Affordable Care Act (ACA), states are required to establish health insurance exchanges by 2014. In the wake of the Supreme Court’s decision affirming the law, some states are progressing toward making the exchanges a reality, while others are choosing not to do so. Under the law, states that do not set up such exchanges by January 2013 will have to pay to set up the exchange, but the federal government will take over the administrative operations.

Alaska:  Alaska Governor Sean Parnell announced on July 17th that the state will not set up a health insurance exchange, instead allowing the federal government to do so. The Governor explained that such action would eliminate uncertainty over implementation and federal approval and that using state funds to design and implement the program would have been too expensive.

Kentucky:  Governor Steve Beshear issued an executive order on July 17^th establishing a statewide health insurance exchange for Kentucky.

Michigan:  Although the state has $9.8 million in federal funds due to expire in November, it remains at an impasse in its effort to establish a health insurance exchange. The Michigan Senate approved legislation for the exchange, but is waiting for action by the House. As some Republican legislators have indicated that they wish to wait until after the election to act, the Republican House Speaker stated last week that he would not move forward on the issue until the House holds hearings. Although the Governor could establish the program by executive order, at this point he continues to encourage legislative leaders to make progress on creating an exchange. 

Minnesota: On July 16^th, the state announced that it signed a $41 million contract with Maximus, a Virginia-based firm, to design and maintain its state health insurance exchange through 2014.