Fla., N.H. only undecided states in health insurance exchanges

January 13, 2013

Only two states — New Hampshire and Florida — failed to meet the Dec. 14 deadline to decide on a way to implement a health insurance exchange system, as required by the Patient Protection and Affordable Care Act.

The two offer the last of the business opportunities for these exchanges, which have provided a boost for technologies specializing in health information technology.

New Hampshire is actively resisting the requirement. In September, the state passed legislation prohibiting the establishment of a state-based exchange, but outgoing Gov. John Lynch passed the decision over what to do about that to incoming Gov. Maggie Hassan and legislative leaders.

The state could still participate in a partnership exchange with the federal government, but this type of exchange would require approval from a joint legislative oversight committee set up by state Republicans to prevent the state’s insurance commissioner from implementing the law on his own.

New Hampshire now has until Feb. 15 to declare its intent to use a partnership model. If the state remains quiet, it will have to use a federally-facilitated exchange by default.

Florida has also demonstrated opposition to President Obama’s Affordable Care Act since it became law in March 2010.

Only recently has the state even started to consider options for an insurance exchange. Florida missed the Dec. 14 deadline because state officials did not believe they had enough information about the exchange’s costs to make a final decision.

Because the state has been so sluggish, it may have no choice but to use the federal exchange. Florida has until Feb. 15 to declare its intention to use a state-federal partnership exchange model, or it will be defaulted to the federal version.

Even if these straggling states opt for the federal exchange, they may still need the services of contractors.

Arizona, for instance, will not be implementing a state-based exchange, after Gov. Jan Brewer cited the high cost and unanswered questions about implementation. Still, the state has awarded a $48.5 million contract to Xerox — the value of which has been since downsized to exclude state-based activities —to provide health exchange component interface services.

Florida and New Hampshire may need consumer-assistance services, such as call centers or navigators. Contractors able to provide these kinds of services should look to states still seeking the best way to serve individuals who will be signing up for plans.

Amanda White is a research analyst at Herndon-based Deltek, which conducts research on the government contracting market and can be found at www.deltek.com.

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