In a January 18, 2012 report, the White House stated that all states have “taken some action to implement health reform,” and that 28 states and the District of Columbia are “on their way toward establishing their own Affordable Insurance Exchange.” The report, titled “2012 Progress Report: States Are Implementing Health Reform,” includes writeups on the progress being made toward the establishment of exchanges in 10 states: Alabama, Colorado, Idaho, Michigan, Minnesota, Mississippi, Nevada, New York, Pennsylvania, and Rhode Island.
The Patient Protection and Affordable Care Act (PPACA) requires that exchanges be operating in all states by January 1, 2014, allowing individuals and small businesses to buy private health insurance that covers “essential health benefits” as defined pursuant to PPACA. The White House report highlights “the diversity of approaches and progress being made” toward this goal.
In addition to the 28 states in which exchanges were said to be in progress, the report points out that Massachusetts and Utah had “Exchange-like structures in place” prior to PPACA. Other states “have indicated an interest in establishing an Exchange.” States that do not wish to establish their own exchanges may participate in a “Partnership Exchange” in which the state “performs some but not all of the functions of an Exchange,” and the federal government performs the remainder. The report specifically mentioned Arkansas, where Gov. Mike Beebe (D) has announced his intent to participate in a Partnership Exchange.
Thus far, the Department of Health and Human Services (HHS) has issued several rounds of “planning grants” and “establishment grants” to the District of Columbia and all states except Alaska, totaling over $700 million, toward the development of exchanges.