Timeline already tight
The extended SBE deadline, which came just days after President Barack Obama's re-election, compacts an already tight vetting and implementation schedule. HHS is supposed to certify HIX blueprints by Jan. 1, 2013. Those that are certified are supposed to be ready for open enrollment by Oct. 1, 2013 and operational on Jan. 1, 2014.
Observers say the delays and extensions do not necessarily mean that the January 2014 startup will be delayed, but the tight schedule allows little margin for error.
"It's ambitious," says Kansas Insurance Commissioner Sandy Praeger. "I know the health plans are concerned about the ability for HHS to get the products approved when we don't have any essential health benefits assigned. We know what they are in general categories but not specifically."
Praeger says health plans need to see the details around the assigned benefits before they can start their development process. "They have to develop the forms and marketing materials and rates that have to be justified and actuarially sound and approved. There is a lot of work left to be done," she says. "There is time to get it done but it is going to put a crunch on the states. Even if it is a federal exchange, states' departments of insurance have to approve those products after HHS has approved them. As states' departments are concerned, we are worried that we are going to get a flood of filings at the same time and not have the capacity to get it done in a timely fashion."