(Bloomberg) -- With enrollment in state-run health insurance exchanges set to begin a year from Monday, 37 governors have yet to commit formally to a project that was mandated by the Patient Protection and Affordable Care Act.
America’s Health Insurance Plans, an industry lobbyist that represents the nation's major insurers, is gathering in Washington, D.C., this week to talk about the work that needs to be done. States must decide by Nov. 16 whether to build their own exchanges or let the federal government administer all or part the program for them.
Sen. Orrin Hatch (R-Utah) is among the federal lawmakers who have complained that the Obama administration hasn’t offered enough information on how any of those options will work, or how they may differ in cost. He chided Health and Human Services Secretary Kathleen Sebelius last week in a letter about a “lack of transparency” in planning.
“Without specific details provided through the rulemaking process with cost estimates and a clear understanding of the roles and responsibilities of the states and the federal government, states are not in a position to make an informed decision,” wrote Hatch, the Senate Finance Committee’s top Republican.
So far, 13 states and Washington D.C. have told the federal government they’ll run their own insurance marketplaces.
At the three-day State Issues Conference that starts Wednesday, the health insurers will hear from the administration official in charge of helping states build exchanges, Amanda Cowley. They’ll also hear from state leaders such as Bruce Greenstein, the health and hospitals secretary for Louisiana. State officials have said they won’t build a state exchange or expand Medicaid to cover more of the working poor.
“There is an urgent need for more regulatory clarity with respect to exchanges and insurance market reforms,” Dan Durham, executive vice president for policy and regulatory affairs at America’s Health Insurance Plans, said in prepared remarks for a Sept. 12 congressional hearing.
Erin Shields Britt, a spokeswoman for Sebelius’ agency, said the administration has been providing the states with information and guidance for the past two years.
“We look forward to continuing our work with states and will provide additional information and guidance as we move forward,” she said in an email.
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