State Health Insurance Exchanges Pose Pressing Problem for Obama

A host of barriers still confront the healthcare reform law as the White House begins the arduous task of installing health insurance exchanges in states that have decided against establishing ones of their own.

A total of 16 states, most governed by Republicans, have decided against forming their own exchanges, forcing the federal government to step up to the plate itself, The Hill reports. An additional five states seek partnerships with the feds to create exchanges, and four others are considering partnerships.

Obamacare was designed for states to form and operate their own exchanges, providing billions of dollars in grants to finance them. The exchanges are a lynchpin of the Affordable Care Act, envisioned as a way to make buying health insurance as simple as booking an airline flight online.

The Health and Human Services Department can’t use a single template, because states have different insurance markets and different eligibility requirements for Medicaid.

And it’s not as if there’s a lot of time. An exchange is required for every state by Jan. 1, 2014. “There's no way around it — this is a big job,” Sabrina Corlette, a health policy expert at Georgetown University, told The Hill.

Meanwhile, Republicans are trying to figure out the best ways to attack the healthcare reform law, as the opportunities for fighting it in court rapidly dwindle and full repeal looks highly unlikely. House and Senate Republicans tell Politico that they hope to repeal various elements of Obamacare with the support of moderate Democrats.