Six states get an early greenlight on health exchanges from HHS

The Obama administration also gave conditional approval on Monday to six states -- all led by Democratic governors -- that were the first to meet the health law's rules for setting up health insurance marketplaces.

The New York Times: Obama Approves Health Insurance Marketplace In 6 States
The Obama administration gave conditional approval on Monday to health insurance marketplaces being set up by six states led by Democratic governors eager to carry out President Obama's health care overhaul. … At the same time, the administration rejected pleas from other states that want to carry out a partial expansion of Medicaid, to cover fewer people than the president and Congress originally intended. Some states want to expand Medicaid to cover childless adults with incomes up to the poverty level, $19,090 for a family of three (Pear, 12/10).

Bloomberg: First Six State Health Insurance Markets Approved By U.S.
Six U.S. states became the first to meet Affordable Care Act rules for the creation of marketplaces by 2014 where local residents can buy medical insurance. Colorado, Connecticut, Massachusetts, Maryland, Oregon and Washington, all states with Democratic governors, have made enough progress building their health-insurance exchanges to receive conditional approval to begin enrolling members in October 2013, the U.S. Department of Health and Human Services said yesterday in a statement. The six represent less than half of the 14 states that have told the U.S. they will set up the online exchanges (Wayne, 12/11).

The Hill: HHS Approves 6 State-Run Health Care Exchanges
The states approved Monday were the first six to apply, officials said. "This is not a reflection on whether any other state will be approved," said Gary Cohen, the director of HHS's Center for Consumer Information and Insurance Oversight, which is handling the bulk of the implementation effort for President Obama's signature healthcare law (Baker, 12/11).

The Associated Press/Washington Post: Maryland Gets Conditional Approval To Operate Health Insurance Exchange
Maryland has received conditional approval by the federal government to operate a state-based health insurance exchange in 2014, Lt. Gov. Anthony Brown announced Monday (12/10).

Baltimore Sun: Feds Approve MD Health Exchanges
Maryland and five other states received conditional federal approval Monday to operate a state exchange, or marketplace where individuals can buy insurance under health care reform. The approval by the Centers for Medicare & Medicaid Services means that Maryland is on track under federal guidelines to operate an exchange during open enrollment next October. Most aspects of health reform will be implemented in 2014. ... Maryland already has received $157 million in federal grants for its exchange. Maryland was one of the early supporters of health care reform and began building an exchange even as the law's constitutionality was challenged in the courts and its future faced uncertainty because of last month's election (Walker, 12/10).

HHS also provided more details about the operation and oversight of these exchanges -

CQ HealthBeat: HHS: States With Federal Exchanges Will Retain Oversight Of Their Insurance Markets
New details emerged Monday on how federal exchanges will operate in states that decline to establish their own exchanges, accompanied by a pledge from the Obama administration that it will strive to allow states to continue their traditional oversight of insurance plans. The question of control enters a sensitive political territory, since states that likely will be home to federal exchanges generally also have Republican governors who have been the most resistant to implementing the health care law (Norman, 12/11).

In other news regarding health exchanges -

The Associated Press: Haslam Says No To State Health Insurance Exchange
Gov. Bill Haslam announced Monday that Tennessee will not create a state-run health insurance exchange, but the Republican governor said he remains undecided about whether to expand Medicaid. Haslam said in a speech to the Nashville Rotary Club that he was unsettled by the lack of guidelines from the federal government about the insurance marketplaces that are required under President Barack Obama's health care overhaul (Schelzig, 12/10).

Health Policy Solutions (a Colo. news service): Annual Tab For Colorado Health Exchange About $25 Million
Colorado's new health exchange will cost an estimated $22 million to $26 million a year starting in 2015, spurring managers to consider advertising, taxes on insurance companies or fees charged to employers and consumers using the exchange to pay for it. The U.S. Department of Health and Human Services formally approved Colorado's exchange on Monday, making the state one of the first six in the country to be approved to open for enrollment next October. Other states that will use a federally-run health exchange will pay fees of about 3.5 percent on the premiums that each person pays per month. Colorado's managers aren't certain they'll charge user fees because they don't want health insurance costs to go up when people are already struggling to pay for insurance. Managers here pledged that they will keep costs lower than those the federal exchange will charge. Health exchange board members have not yet voted on how to pay for Colorado's exchange and some funding proposals would require legislative approval (Kerwin McCrimmon, 12/10).

(St. Paul) Pioneer Press: Grassley Says UnitedHealth Acquisition Poses Possible Health Exchange Monopoly
Congressional Republicans are questioning whether a recent acquisition by Minnetonka-based UnitedHealth Group raises concerns about conflicts of interest in the development of health insurance exchanges. In a letter issued Monday, Dec. 10, Sen. Charles Grassley, R-Iowa, asks a series of questions related to a UnitedHealth acquisition of Quality Software Services Inc., or QSSI, a Maryland company that has a federal contract to build a database hub for health exchanges…."This contract creates a situation whereby the exchange's ultimate designer, QSSI, is in a position to tailor the system to favor the interests of its parent company, UnitedHealth Group, and further maintain a monopoly over information that is unavailable to competitors," Grassley wrote in a letter also signed by U.S. Rep. Fred Upton, R-Michigan (Snowbeck, 12/10).