With only six months until the start of open enrollment for Obamacare, state and federal health officials are racing to get insurance regulations and systems up and running in time.
"The Feds are saying they're on track and the system is being tested, and they're working out the kinks," said Sabrina Corlette, research professor at the Health Policy Institute at Georgetown University. Still, she added, "There's a pretty steep uphill climb yet, before October 1, 2013."
The biggest challenge remains building out the IT infrastructure that will provide the backbone for enrollment—the new state health insurance exchanges that will serve as the gateway for individuals to obtain insurance under the Affordable Care Act and find out whether they qualify for Medicaid or insurance subsidies.
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Beyond the infrastructure, the final regulations aren't there yet, either. The Department of Health and Human Services is still finalizing rules for insurers about what kinds of plans and rates they can offer on exchanges, along with new rules for states about how eligibility for Medicaid coverage will be calculated.
"The rules continue and the material continue to come out," said Karen Ignagni, president and CEO of America's Health Insurance Plans. "I think in another month, we'll have a much better sense than we do today."
With rules still in flux, the major insurers are still not sure to what extent they will be offering plans on the new state exchanges.
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Aetna has said it plans to sells plans on more than a dozen states exchanges. WellPoint has said it plans to participate in states where it operates.