About 30 states will not move forward on creation of state-based exchanges until after both a U.S. Supreme Court decision on the federal healthcare overhaul and the November presidential election, according to the head of the agency. Acting CMS Administrator Marilyn Tavenner told a Washington gathering of accountable care organization advocates and experts that the large number of states stalling on the insurance marketplaces required by the law is one of her leading concerns. “What keeps me up at night is knowing around December, there are going to be like 30 states who want to come in and be state-based exchanges, so we are trying to do a lot of quiet preparation, if you will, in the background to make sure we are ready for that,” Tavenner said. A Supreme Court decision is expected this month.
Late News: Numerous states stall on creating exchanges
Mitt Romney, the presumptive Republican presidential candidate, has promised to lead the law's repeal if he is elected. Under provisions of the Patient Protection and Affordable Care Act, any state that does not receive CMS certification in January 2013 that its exchange is likely to meet the operational deadline of January 2014 will have an exchange created by the federal government. The CMS has proposed rules to allow hybrid exchanges that would allow state control of some components if they are not prepared to operate the entire marketplace. Officials from some of the states declining to advance exchanges have attended CMS meetings about what's required to establish them, Tavenner said. After the election, “they will want to be state-based because most states like their independence; they like control of their own programs, as we have seen with Medicaid.”
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