6 states’ health exchanges OK’d

WASHINGTON — Health insurance marketplaces under development in six states have been conditionally approved by the federal government as meeting requirements of the 2010 health-care law.

Exchanges in Colorado, Connecticut, Massachusetts, Maryland, Oregon and Washington can start to sell policies to residents who don’t get medical coverage through their jobs beginning in 2014, the Department of Health and Human Services said Monday in a statement. The six represent almost half of the 14 states that have told the United States they will build exchanges.

The rest of the states have until Friday to decide whether to follow suit, let the U.S. run the markets or provide services such as consumer assistance in a partnership with the federal government. Kathleen Sebelius, the U.S. health secretary, said in a blog post she expects “the majority of states will play an active role operating their exchanges.”

Arkansas has said it plans to operate a federal-state exchange.

The Affordable Care Act is expected to extend coverage to about 30 million Americans who would otherwise lack health insurance. Congressional budget projections show that more than half of those people would buy subsidized plans through the exchanges and 11 million would become eligible for Medicaid, the state-run insurance program for the poor.

The Medicaid portion of the law is dependent on state cooperation after the Supreme Court ruled June 28 that governors can opt out of the expansion. Some governors asked Sebelius if they could expand Medicaid by less than what the Obama administration wants while still taking advantage of a 90 percent federal reimbursement.

Arkansas lawmakers are still considering whether to expand Medicaid.

The Obama administration said Monday that states won’t get full federal support for expansions of Medicaid that fall short of the level directed by the health law.

The law calls for Medicaid to expand to cover everyone making as much as 138 percent of the poverty level, or about$31,809 for a family of four this year. The U.S. will pick up the full cost of the expansion until 2017, when federal reimbursement begins to decline to 90 percent of the cost.

If the U.S. approves smaller expansions, states will be reimbursed at the usual federal match rate, which varies from 50 percent to 74 percent this year, depending on the state.

“The enhanced match rate is a rate Congress reserved for the full expansion,” said Cindy Mann, the U.S. Medicaid director. “We are going to remain true to that intent of Congress.” Information for this article was contributed by the Arkansas Democrat-Gazette.