The Affordable Care Act (ACA) requires states to establish health insurance exchanges to provide individuals and small employers with access to affordable insurance coverage beginning January 1, 2014. States have the flexibility to design and operate exchanges that best meet their needs while complying with the ACA’s statutory and regulatory standards. A state that chooses to establish its own exchange or participate in a partnership model must complete and submit an exchange blueprint that documents how it will meet all the legal and operational standards. A state also must demonstrate operational readiness to carry out exchange activities as part of its exchange blueprint.
Decisions on whether to establish a state exchange and blueprint submissions are due to the U.S. Department of Health and Human Services (HHS) by November 16, 2012. Although states still must inform the HHS if they plan to establish an exchange by that date, the agency has extended the date for submitting blueprints to December 14, 2012. If those deadlines aren’t met, the HHS will implement a federally facilitated exchange for the states and perform exchange activities.
In her letter to governors announcing the blueprint extension, HHS Secretary Kathleen Sebelius stated that the agency will approve or conditionally approve state-based exchanges for 2014 by the statutory deadline of January 1, 2013. Additionally, for states pursuing a state partnership exchange, she said the HHS will accept declaration letters and blueprint applications and make approval determinations on a rolling basis. The final deadline for both the declaration letter and the blueprint application for state partnership exchanges that will take effect in 2014 has been extended to February 15, 2013.