The Health Exchanges Start To Take Shape In Various States

Now the regulatory fun begins in earnest — with seven states approved to run their own exchanges, and one still pending (Mississippi).  [Background here.] It seems likely a total of at least 18 states will run some version of a state-only, or federal-state joint exchange. The others are likely to be under an all-federal solution.

All of this via the able reporting of tonight’s edition of The Wall Street Journal — do go read it all:

. . .[With Utah, the] other states whose exchange proposals won conditional approvals are California, Hawaii and Vermont, which all have Democratic governors, and Idaho, Nevada and New Mexico, where Republican governors have said they oppose the law but want to retain control over their own marketplaces. None of those states have signaled that they want to run exchanges that significantly differ from the outlines in the federal law.

Federal officials also said they were holding off on making any decision on a proposal by Mississippi to run its own exchange because of disagreements among Republican lawmakers in the state over the issue.

When the health law was passed in 2010, its architects envisaged that states would set up exchanges for millions of Americans to buy regulated insurance policies and apply for federal tax subsidies toward the cost of premiums starting this October. In many states, opponents of the law have blocked the creation of such exchanges, meaning that Washington will step in to run them. The Obama administration has just nine months remaining to set up such exchanges, and to ensure that states that do want to run their own or take on some operating responsibilities are ready.

A total of 18 states have signaled they wanted to set up their own exchanges. States have until February to decide whether they want to sign up for some operating responsibilities.. . . .

We will keep you posted.

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