WASHINGTON Jan 3 U.S. officials on Thursday
gave four states currently governed by Republicans the green
light to set up their own health insurance exchanges under
President Barack Obama's healthcare reform law, an initiative
largely opposed by Republicans.
The U.S. Department of Health and Human Services said Idaho,
Nevada, New Mexico and Utah joined a list totaling 17 states and
the District of Columbia that have all won conditional approval
to establish their own state exchanges, with operations set to
begin on Jan. 1, 2014.
A fifth Republican-governed state, Mississippi, applied to
operate a state exchange, but has not received approval because
of a dispute about how much authority state officials should
exercise over the operations of its prospective online
marketplace, officials said.
The U.S. administration also cleared an exchange that
Arkansas plans to run in partnership with the federal
government. Delaware received approval for a similar partnership
exchange late last year. Both Arkansas and Delaware have
Health exchanges are a central provision of Obama's Patient
Protection and Affordable Care Act. The marketplaces would
extend health coverage to an estimated 16 million uninsured
people by allowing them to purchase private insurance at prices
subsidized by federal tax credits.
In a conference call with reporters, U.S. Health and Human
Services Secretary Kathleen Sebelius welcomed the advent of
exchanges as "a brand new day" for U.S. healthcare that would
"drive down costs" for consumers through competition.
But the plan is opposed by many Republicans, including
Republican state governors, who view the healthcare law as a
costly and unnecessary expansion of government bureaucracy.
The federal government is likely to end up operating
exchanges in at least 32 states that have not applied to run
their own. States have the choice of rejecting the exchange
provision outright, or following Delaware and Arkansas by
participating in federal partnership exchanges that would allow
them to manage insurance plans and aid consumers.
The deadline for states to declare their intentions to run
federal partnership exchanges is Feb. 15.
Oklahoma, which rejected Obama's healthcare reforms, is
asking a U.S. judge to prevent the administration from using tax
credits to subsidize insurance sold in any federal exchange
operating within its borders.
U.S. officials could not predict how long it might take to
clarify Mississippi's status. But they said states that are
unable to begin open enrollment by October can apply in November
to run their own marketplaces in 2015.
"We will continue to work with (Mississippi) state officials
as they determine how best to resolve these issues," Gary Cohen,
the U.S. official leading the administration's exchange
implementation effort, told reporters.