Health Care

GAO warns CMS exchanges behind schedule

health insurance form

The Centers for Medicare & Medicaid Services is overseeing the development of health insurance exchanges—online marketplaces for comparing and selecting insurance plans -- mandated by the Patient Protection and Affordable Care Act. Unfortunately, a new Government Accountability Office report found, many of the steps required to hit a key October deadline are either incomplete or behind schedule.

The "Obamacare" law mandates that all states establish these exchanges. CMS is establishing federally facilitated exchanges (FFEs) in 34 states; other states, with CMS approval, are creating their own state-based exchange. Enrollment in exchanges will begin on Oct. 1, 2013, with health coverage becoming effective on Jan. 1, 2014.

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GAO reviewed CMS’s progress in developing FFEs and found that many of the tasks necessary before the October deadline were either incomplete or behind schedule. One critical task is the development of an electronic data hub to determine an individual’s eligibility to enroll in health insurance plans offered by the exchanges. The goal of this data hub is to "provide electronic, near real-time access to federal data, as well as provide access to state and third party data sources needed to verify consumer-eligibility information," the report stated.

Data hub testing with several agencies that will provide information on consumer eligibility (such as SSA, DHS and VHA) was planned for April, but did not begin until May. "While the missed interim deadlines may not affect implementation, additional missed deadlines closer to the start of enrollment could do so," GAO warned. "Much remains to be accomplished within a relatively short amount of time."

CMS officials, acknowledged the missed deadlines, but responded to the report by saying they had confidence the exchanges would be up and running in every state by Oct. 1.

About the Author

Natalie Lauri is an editorial fellow at FCW. Connect with her on Twitter: @Nat_Lauri.

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