U.S. Extends Deadline on Health Coverage for States





WASHINGTON — With many states lagging far behind schedule, the Obama administration said Friday that it would extend the deadline for them to submit plans for health insurance exchanges, the online markets where millions of Americans are expected to obtain private coverage subsidized by the federal government.




The original Nov. 16 deadline will be extended to Dec. 14 — and in some cases to Feb. 15, the administration said.


The Congressional Budget Office predicts that 25 million people will obtain coverage through the new online shopping malls known as insurance exchanges. Most of them will receive federal subsidies averaging more than $5,000 a year per person to help them pay premiums.


Every state is supposed to have an exchange by Jan. 1, 2014, when the federal government will require most Americans to have insurance. Many states delayed work on the exchanges to see the outcome of a Supreme Court case challenging the health care law, then waited to see if President Obama would be re-elected.


If a state wants to run its own exchange, its governor still must submit a declaration of intent — generally a brief letter of one or two pages — by Nov. 16. But states will have more time to submit the detailed applications required by federal officials.


The White House has repeatedly said that states were making excellent progress toward creation of the exchanges, even as Republican governors and state legislators expressed ambivalence or outright opposition. In addition, state officials who want to establish exchanges said they were having difficulty because Mr. Obama had yet to issue crucial regulations and guidance.


In a letter to governors on Friday, Kathleen Sebelius, the secretary of health and human services, said that many states had asked for “additional time” to submit applications indicating whether they wanted to run their own exchanges or help the federal government run exchanges in their states.


Under the Affordable Care Act, the federal government will run the exchanges in any states that are unable or unwilling to do so. Fewer than half the states have indicated that they will set up their own exchanges.


If states want to run their own exchanges, Ms. Sebelius said, they will have until Dec. 14 to submit applications, or blueprints. And if states want to run exchanges in partnership with the federal government, she said, they will have until Feb. 15 to file applications.


Ms. Sebelius said the new timetable would not defer the dream of affordable insurance for millions of Americans.


“Consumers in all 50 states and the District of Columbia will have access to insurance through these new marketplaces on Jan. 1, 2014, as scheduled, with no delays,” Ms. Sebelius told governors. “This administration is committed to providing significant flexibility for building a marketplace that best meets your state’s needs.”


Senator Orrin G. Hatch of Utah, the senior Republican on the Senate Finance Committee, said the change in the deadline was “no surprise” because the White House had not given states enough information or guidance to make decisions.


“Frankly,” Mr. Hatch said, “the fact that the exchanges are such a mess is pretty emblematic of how flawed the president’s health law is — with states having to bear the brunt.”


Representative Charles Boustany Jr. of Louisiana, a spokesman for House Republicans on health policy, said he doubted that extending the deadline would make the law any more workable.


Even in states where governors want to establish insurance exchanges, they need legal authority to do so, and Republican legislators have balked in some states.


Federal officials hope that fierce competition among insurers offering health plans in the exchanges will drive down premiums.


Joel S. Ario, a former director of the federal office for insurance exchanges who now advises states as a consultant at Manatt Health Solutions, said: “The administration’s decision is a good move. It increases the chances that more states will opt for a partnership exchange, rather than default to a federal exchange.”


An administration official said that Mr. Obama was on schedule in carrying out the law, and that starting in October, Americans will be able to enroll in health plans for coverage starting in January 2014.


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U.S. Extends Deadline on Health Coverage for States