Only 15 states have told HHS that they will develop their own online insurance exchanges. This means the government has to design 35 different sites, with 35 different criteria for coverage -- all by next year.
Only 15 states have told the federal government they plan to operate health insurance exchanges under President Barack Obama's reform law, leaving Washington with the daunting task of creating online marketplaces for two-thirds of the country.
On the eve of a federal deadline for states to say whether they will run their own exchanges, a top health care policy official told lawmakers that the exchanges will start enrolling eligible families starting on Oct. 1.
"I am confident that states and the federal government will be ready in 10 months, when consumers in all states can begin to apply," Gary Cohen, director of the Center for Consumer Information and Insurance Oversight, told a House panel.
Cohen was among federal officials who testified alongside state health authorities at a hearing of the House Energy and Commerce Subcommittee on Health.
In written testimony, Cohen said that while 15 states have told the administration they will operate exchanges, 11 others have opted for versions that will require major involvement by the federal government.
Experts say the number of states planning to operate their own exchanges could reach 18, plus the District of Columbia, by the time the deadline arrives Friday.
But the administration would still be left to set up exchanges in at least 30 states, a challenge that is raising questions about how successfully U.S. officials can implement a key provision of the health care reform law.
Some of the non-cooperation is passive resistance to Obamacare. But the reality is, cash strapped states would rather spend the millions of dollars to develop a web site on other, more vital projects than an optional rule from the feds.
Despite the confident words, it will be a stretch for Washington to build and get up and running this many web sites before October 1.