Progress report on health exchanges: Will states, feds be ready?

States face a Friday deadline to indicate whether they plan to establish their own online health insurance markets, or allow the federal government to do it.  Meanwhile, debate continues about whether delays in updating essential software and other glitches could delay the start of enrollment in the markets beyond the Oct. 1, 2013 target specified in the health law.

Kaiser Health News: States Count Down To Decisions On Health Exchanges
With a federal deadline looming Friday, 10 states remain undecided about whether to build state-based online insurance markets designed to help millions of people buy health coverage starting next October (Galewitz and Tran, 11/14). 

Kaiser Health News: Computer Issues May Hamper Online Markets
New online insurance markets set to begin selling health coverage to consumers next October may be hampered by delays in launching a key computer program, according to state consultants and insurance regulators. State regulators learned late last week that an electronic system most insurers will use to submit their policies for state and federal approvals won't be ready for testing next month, as originally planned. The lag is being blamed on the wait for several regulations from the Obama administration, which are needed to update the software (Appleby, 11/14). 

CQ HealthBeat: Top HHS Official: Exchanges Will Be Ready To Go By October
Health insurance exchanges in the states will be up and running by the time enrollment begins in October 2013, a top Health and Human Services official vowed Wednesday, just two days before the deadline for states to declare whether they will operate their own exchanges. Michael Hash, director of the HHS Office of Health Reform, also said that on Jan. 1, the department will announce those states that have been approved to run their own exchanges. By Friday, states that want to operate the new marketplaces on their own must let HHS know, although under a new timeline announced last week they have another month to submit additional required paperwork (Norman, 11/14).

The New York Times: Health Law Has States Feeling Tense Over Deadline
The days since President Obama won re-election have been marked by tension and angst in Republican-led states like Iowa, where Gov. Terry Branstad has waited until the last minute to decide whether to create a crucial tool for people to get medical coverage under Mr. Obama's health care law (Goodnough and Cooper, 11/14).

McClatchy: States Face Friday Deadlines On Health Insurance Exchanges
With the prospect of outright repeal all but gone, the nation's health care overhaul is proceeding, and states that once resisted the politically divisive law now must decide how to implement its most innovative aspect: the online health-insurance shopping malls known as exchanges. Beginning next year, the law requires states to establish Internet marketplaces in which individuals can compare and purchase private health insurance or, if eligible, enroll in public Medicaid coverage. States that want to run their own exchanges without federal involvement have until Friday to notify the Department of Health and Human Services, but they get until Dec. 14 to provide the details (Pugh, 11/14).

Modern Healthcare: Setting Up Exchanges May Be Tough For Latecomers, Experts Say
States that have waited until after the Nov. 6 federal election to decide to pursue an insurance exchange face an "enormous lift" that could limit the number that will operate such a marketplace, according to exchange experts. A leader of the Maryland exchange, which state officials have spent two years designing and building, questioned the ability of states to begin planning now and start enrolling beneficiaries by October 2013 (Daly, 11/14).

In related news, GOP governors are asking for more time and information before they have to make decisions about whether to carry out key provisions of the health law -  

Los Angeles Times: Republican Governors Want More Time To Implement Healthcare Law
In a letter to the president Wednesday, Virginia Gov. Bob McDonnell and Louisiana Gov. Bobby Jindal, the current and incoming chairmen of the Republican Governors Assn., said governors do not have enough information to assess whether they should operate their own insurance exchanges in 2014 or leave the job to the federal government (Levey, 11/14).

CQ HealthBeat: GOP Governors Press Obama On Exchanges And Medicaid
Republican governors meeting in Las Vegas on Wednesday sent a letter to President Barack Obama asking for answers to their questions about the health care law, requesting greater flexibility in the state-run exchange deadline and seeking a meeting on Medicaid. "States are struggling with many unanswered questions and are not able to make comprehensive, far-reaching decisions prudently," said the letter, signed on behalf of the Republican Governors Association by outgoing chairman Bob McDonnell of Virginia and incoming chairman Bobby Jindal of Louisiana (Adams, 11/14).

CQ HealthBeat: Fed Decision On Partial Medicaid Expansion May Wait Until Summer, Salo Predicts
State officials may have to wait until summer to get a key piece of information they need to help them decide whether to expand their Medicaid programs under the health law -; whether the Obama administration will permit a partial expansion, a top state Medicaid representative predicted Wednesday. States have precious little time to gear up for the 2014 start of coverage expansion, but the administration could delay a decision on partial expansion until July, Matt Salo, executive director of the National Association of Medicaid Directors, told business executives at a Washington, D.C. meeting of the National Business Coalition on Health and in an interview afterward (Reichard, 11/14).