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HHS Turns Health Insurance Exchanges Into Marketplaces

Jacqueline Fellows, for HealthLeaders Media, January 23, 2013

Last week, Department of Health and Human Services Secretary Kathleen Sebelius started using the term health insurance marketplaces instead of health insurance exchanges, and critics pounced. For the purposes of this column, I will refer to them the same way the Patient Protection and Affordable Care Act does—health insurance exchanges.

The PPACA-mandated exchanges are due to be up and running by October for open enrollment and the regulations being formulated to help guide their development  are still, as one state official put it, "very fluid" just eight months out.

The exchanges are unpopular among Republicans. Nearly every state leaving the planning and operation of the health insurance exchanges is led by a GOP governor. And, it is true that states are not clamoring to run the exchanges on their own or partner with the federal government. 

Anti-Obama groups such as FreedomWorks characterize the department's departure from using the term "exchanges" as a desperate attempt to attract states to partner with the federal government on operating health insurance exchanges.

Ed Haislmaier, senior research fellow and the conservative-leaning Heritage Foundation calls it a public relations move. "It's the corporate theory of 'We'll get the dogs to eat the dog food if we change the name of the brand'... this is all PR. That's what's going on here," he says.

HHS shed no light on the subject of why it started calling exchanges marketplaces, pointing only to the January 16 blog post by Sebelius that started the dust up. Sebelius writes:  "January is the perfect month for looking forward to new and great things around the corner. I'm feeling that way about the new Health Insurance Marketplace."

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