In a letter sent to governors Friday, HHS Secretary Kathleen Sebelius set new deadlines for applications. States planning for a state-run exchange must send a letter of intent by Nov. 16, the original deadline for applications, but the full blueprint isn't due until Dec. 14. HHS still plans to grant either full or conditional approval to those plans by Jan. 1, 2013.
States that decide to create a state-federal partnership exchange have until Feb. 15 to submit their blueprints to the administration. Otherwise, states are opting for a federal-run exchange, although HHS has said states could transition to a state or partnership exchange in later years.
The exchanges, which will sell health insurance plans and offer federal tax subsidies as prescribed under the Affordable Care Act (ACA), are supposed to open for enrollment on Oct. 1, 2013. More than 20 million people are expected to use them.
As Governing wrote earlier, some governors have made their exchange plans known since Obama won reelection Tuesday. Several GOP governors have said they will have a federal exchange, thereby effectively washing their hands of the programs (and the ACA) if they are a failure.
Federal officials have said privately that they expect to run up to 35 exchanges in the first year. About 20 states, at the most, are expected to have a state-run exchange, according to an analysis released this week by Avalere Health, an independent consulting firm. Only one (Arkansas) has publicly committed to a parternship exchange.
