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A Case Study in Uncertainty

Nov 16, 2012
States Still Waiting for HHS to Provide States Guidance on Health Exchanges

WASHINGTON, DC – Late yesterday, HHS announced states would have one more month to decide how and whether to implement Obamacare’s health exchanges. This last-minute reprieve came on the eve of the original decision deadline, an arbitrary cutoff date that states were struggling to meet because they lack basic information about this aspect of the law and how it will be implemented and regulated. The law's backers claim they envisioned the federal government operating an exchange only as a last resort, but they are failing to provide the information states need in order to establish these structures in a way that will best meet the needs of their citizens. With states facing uncertainty and a lack of flexibility, the result is likely to be an even bigger federal role.

The Washington Times reported that Virginia Gov. Bob McDonnell "said Republican and Democratic governors have written to the federal government with questions, for example, on the services that must be covered by certain plans under the new law starting in 2014 or what it will mean for the expansion of Medicaid, the federal-state health care program used by people who do not have insurance and cannot afford to purchase it. They essentially have received no guidance, he said."

The Energy and Commerce Committee has repeatedly pressed HHS to outline the exchange rules. On August 20, members wrote, "The regulatory uncertainty has crippled sates and health providers in their ability to plan for future Medicaid expansions and state insurance exchanges." When HHS failed to reply, the committee spoke out again, "governors and legislatures have been left to navigate alone the regulatory maze created by the absence of guidance from your department."

If HHS’ lack of cooperation is any indication of what states can expect moving forward, it is no wonder states are hesitant to undertake this enormous operation.

While the Obama administration refuses to provide answers to basic questions, the cloud of uncertainty related to Obamacare implementation and the future of American health care has only grown.