States seek help making health exchange rules

Kelly Kennedy, USA TODAY

Limited guidance meant to give states room to develop individualized health exchanges may be hampering their ability to meet a Nov. 16 deadline to let Washingtonknow if they will create their own.

1:34PM EDT October 29. 2012 – WASHINGTON – As the federal government tries to leave the states with the freedom to set up individualized local health exchanges, state officials say they’ve received so little guidance that they’re afraid they’ll have to make changes as moreregulations come out after the presidential election.

“CMS is walking a very fine line with providing guidance while trying not to be too prescriptive,” said Kevin Counihan, CEO of Connecticut’s Insurance Exchange. “We can either say, ‘I don’t know enough to move,’ or, ‘We’re going to do the best we can with what we have.’ If we do something wrong, we can beg the government for forgiveness later.”

The states are rushing to meet a Nov. 16 deadline to let Washington know if they will create their own health exchanges or participate in the federal program. But because only two states — Massachusetts and Utah — had the systems before the 2010 health care law was enacted, most of them are starting from scratch. And they’re finding that limited guidance from the feds means that state officials need to answer some hard questions, such as whether acupuncture should be acovered benefit, or exactly what meets government regulations for mental health care, or whether they should pay for surgeries meant to help people who areobese.