A last-minute delay of a deadline for states to declare whether they plan to operate a health insurance exchange could spur more states to do so, according to some health policy experts.
HHS Secretary Kathleen Sebelius wrote Republican governors on the eve of the Nov. 16 deadline to declare their intent on running their own health insurance marketplaces, giving states another four weeks to decide. Her letter followed a Nov. 14 plea from Republican governors for more time to weigh a decision that has huge organizational and fiscal consequences for states.
“Now that the election is over, states need additional time to look at the different options in deciding on setting up their own exchanges, so it's a very good move and it will certainly encourage some states” to set up their own exchanges, Tom Nickels, chief lobbyist for the American Hospital Association, said in an interview.
Hospitals generally prefer states to operate their own exchanges, according to their state and federal advocates, because states are better able to tailor the marketplaces to their own specific mixes of patients and providers. State hospital groups have reported mixed success in their efforts to encourage resistant governors and legislators—mostly Republicans—to pursue the state-run version because of political leaders' concerns about the costs of the exchanges and because of opposition to the underlying law.