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Testimonial

The ways in which the federal government is set to introduce and implement the health insurance exchanges put in place by the Affordable Care Act has come under significant scrutiny in recent months as the deadline for enrollment approaches. Now, a nonpartisan government agency indicates these problems may be very troubling to properly provide consumers and companies alike access to the marketplaces.

The health insurance exchanges are slated to open for enrollment on October 1, with an eye toward the ACA's coverage mandate going into effect on January 1, 2014, but this may prove more difficult than some in the federal government might have anticipated, according to a new study from the nonpartisan congressional Government Accountability Office. In all, 34 states will have individual exchanges either partly or fully run by the federal government, and 33 will have the same for Small Business Health Options Programs (SHOPs).

And while both the Centers for Medicare and Medicaid Services (CMS) and state governments alike have been able to at least begin setting up the SHOP exchanges in particular, there have been numerous snags, the report said. For one thing, many SHOP exchanges do not yet even have basic functionality at this point, just a few months away from their predetermined rollout time; they generally lack plans for how eligibility and enrollment will work, the ways in which participants will be able to manage their plans, and receive assistance. CMS put timelines for implementation into place, but in most cases these were behind schedule; through the end of May, just 44 percent of key activities that were supposed to have been completed by March 31 had not been done, and the agency has been revising other such dates as well.

All these issues combine to paint a less-than-positive picture of potential preparedness for the rollout of the exchanges, and the GAO acknowledges that these current missed deadlines do not necessarily mean implementation or enrollment will necessarily be delayed, the report said. In fact, it notes that it believes all states will have “open and functioning” exchanges in every state by the start of October.

Of course, small businesses which will turn to these exchanges to obtain insurance for their employees may need to closely evaluate their needs and the regulations to which they will have to comply when the ACA's coverage mandate kicks in next year.