Congress

House panel seeks GAO probe of state insurance marketplace IT

Shutterstock image (by adirekjob): magnifying glass resting over a missing puzzle piece.

Republican leaders of the House Energy and Commerce Committee are concerned about states' abilities to pay for their online health insurance marketplace systems, and have asked the Government Accountability Office to investigate what officials at the Centers for Medicare and Medicaid Services are doing to help states.

The Affordable Care Act required state-based health insurance exchanges to be self-sustaining beginning Jan. 1, 2015, which is when federal grants ended. However, the lawmakers said they were concerned about states' ability to operate the systems without federal support.

In a letter to Comptroller General Gene Dodaro, committee leaders said they want GAO to examine the costs and challenges facing states that choose to transition to a different marketplace IT platform, any guidance CMS has offered to help states establish self-sustaining systems and the role CMS has taken in overseeing the success of the state-based insurance exchanges in the absence of federal funding.

They also cited the federal government's investment as justification for GAO's examination. "Grant awards [to establish marketplace IT systems] totaled approximately $5.5 billion at the end of December 2014, with 83 percent of the funds awarded to states that chose to establish their own marketplaces" instead of using the HealthCare.gov platform, they wrote.

"Yet, rollout and operation of the marketplaces [have] been problematic for many of these states, as websites froze or crashed, and other technical problems hindered or prevented consumers' ability to enroll" in health care coverage, states the letter, which was signed by committee Chairman Fred Upton (R-Mich.), Health Subcommittee Chairman Joseph Pitts (R-Pa.), Oversight and Investigations Subcommittee Chairman Tim Murphy (R-Pa.) and Communications and Technology Subcommittee Chairman Greg Walden (R-Ore.).

The enrollment process is complex, and requires interactions with several federal agencies to determine the eligibility of applicants. Many states have struggled with IT implementation.  Hawaii, Nevada, New Mexico and Oregon have chosen to use the federal platform for one or more years after encountering IT implementation hiccups.

The lawmakers did not specify a desired deadline for GAO's evaluation.

About the Author

Chase Gunter is a former FCW staff writer.

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