Despite renewed assurances that the federal government will have its insurance exchanges ready to begin enrollments Oct. 1, the senior Senate health policy Democrat demanded more details on the secretive effort.
Sen. Max Baucus, chairman of the Senate Finance Committee, on Thursday required the CMS to provide his panel with the agencies' specific goals for the establishment of federally operated health insurance exchanges and the timeframes for accomplishing those benchmarks.
The status of those exchanges is critical because the CMS may need to launch and operate up to 30 of them in states that do not have either self-operated exchanges or insurance marketplaces operated in tandem with the federal government. But the CMS has generally not specified the status of many of the critical elements of the federal exchanges, even to congressional Democrats.
“We've got to know what we're doing and what we're not doing; we can't just talk, it's deeds not words,” Baucus said after ordering the detailed accounting of the federal exchanges by Feb. 26 from Gary Cohen, director of the Center for Consumer Information and Insurance Oversight.
Cohen assured Baucus and other committee members that the federal exchanges are on track to begin enrolling beneficiaries Oct. 1 and to offer insurance coverage by Jan. 1. Cohen defended the lack of public information provided on the status of the myriad components of the federal exchanges—as well as federal components of the two other exchange models—by highlighting the many private meetings his agency has had with state officials in every state.
Such assurances drew criticism from Republicans, who said many Republican-led states were unable to launch state-run exchanges because the CMS refused to provide critical information needed to launch those marketplaces.
For instance, Arizona had completed many of the steps needed to implement a state-run exchange, a state official said, but it decided to defer to the federal government running its exchange when the CMS failed to provide needed information about needed federal steps.
“We were concerned about whether the federal components would be ready in time,” Don Hughes, adviser to Arizona Gov. Jan Brewer, said at the hearing.
Only 20 states have received tentative approval to use either state-run or partnership exchanges, and not even those may receive final approval to move forward this year, according to the CMS. A final deadline for states to submit applications to operate partnership exchanges is Feb. 15.
Officials from two states attempting to launch either a state-run or a partnership exchange said they have received enough information in their private conversations with CMS officials that they are confident their exchanges will operate on schedule.
“We made a calculation that they would get us what we needed in time to get it done,” said Christine Ferguson, director of the Rhode Island Health Benefit Exchange.
Ferguson said her state most needs more details on the “technical information” related to the exchange. However the lack of finalized rules on essential health benefits, insurance market reform rules or other major exchange elements were not slowing their exchange's progress, she told reporters.
Bettina Tweardy Riveros, chair of the Delaware Health Care Commission, said her state was “on track” to complete the steps it was required to finish for the partnership model it is pursuing.
Federal steps needed to launch the various types of exchanges on time remain on schedule, Cohen said. Specific completed steps included agreements signed between all federal departments that must share information through a federal data hub to determine whether applicants are eligible for either enrollment or premium subsidies.
Cohen also assured committee members that such complex federal data will be shared in “real time” on Oct. 1—a critical logistical accomplishment that was frequently questioned by exchange experts.
Cohen also highlighted a range of next steps expected in a final dash to the exchanges' October launch, including a national media campaign to begin driving future enrollees to healthcare.gov
for information about eligibility and enrollment in the exchanges.
“Work remains in the coming months,” Cohen said.