Progress Continues in Setting up Health Insurance Marketplaces

By Kathleen Sebelius, Secretary of Health and Human Services
Posted December 10, 2012

Ten months from today, Americans in every state can begin to choose health insurance in new state marketplaces where they will have access to affordable coverage.  Many will have never had health insurance, or had been forced to make the decision to go without insurance after losing a job or becoming sick.  It is a groundbreaking time for health care in our country.

Today, we’re announcing that six states who applied early have made enough progress setting up their own marketplaces or Exchanges that we are ready to conditionally approve their plans—meaning they are on track to meet all Exchange deadlines.  These early applicant, early approval states include: Colorado, Connecticut, Massachusetts, Maryland, Oregon, and Washington. 

We are excited to be reviewing applications from other states making progress in building their Exchange.  We will make many more announcements like this in the weeks and months to come and expect that the majority of states will play an active role operating their Exchanges.

Some states have requested additional information to help guide their work implementing the health care law.  We value the hard work states are undertaking and to ensure that states have all the information they need to move forward, today we are providing more information that will answer some questions states have been asking.  You can read the letter I sent to Governors here (PDF-72 KB).

This letter follows information we have provided to states in the past month to help them build their Exchanges, expand and improve their Medicaid programs, and make health care coverage more affordable for every American.  It answers frequently asked questions by state officials, summarizing previous guidance and offering new information. 

For example, we explain how Exchanges and Medicaid administrative costs will be funded and how we will continue exploring opportunities to provide States additional support for the administrative costs of eligibility changes.  We clarify in our new guidance that states have the flexibility in Medicaid and the Children’s Health Insurance Program to provide premium assistance for Exchange plans as well as to adopt “bridge plans” that offer coverage through both Medicaid and Exchanges – keeping individuals and families together when they cross the line between Exchanges and Medicaid.  And, while the law does not create an option for enhanced match for a partial or phased-in Medicaid expansion to 133 percent of poverty, we will consider waivers at the regular matching rate now and, in 2017 when the 100 percent federal funding for the expansion group is slightly reduced, broad-based State Innovation Waivers.

We hope states will take advantage of the substantial resources available to help them insure more of their residents. As an independent report highlighted, “Accounting for factors that reduce costs, states as a whole are likely to see net savings from the Medicaid expansion.”

Today’s approval for these six early states and our continued effort to give states the guidance and tools they need to move forward, ensures that starting in October 2013, consumers in all states can begin filling out applications for private health insurance in affordable, quality plans.   And our work with states will continue.  If states decide they want to play a larger role in running the new marketplace in their state in 2015, 2016 and beyond, we will work with them so they can have the opportunity to take on that role.  We are excited about the progress we’re announcing today, and we will continue to work side-by-side with states as they implement the critical reforms to our health care system that our citizens need and deserve.