Strategic implications: Which states will get on the exchange bandwagon?

Today, our “Ten strategic considerations of the Supreme Court upholding PPACA” blog series brings us to the topic of state exchanges. With the court’s decision minimizing uncertainty, there may be increased incentive for states to fast-track exchange planning.

Some states have pushed forward aggressively with implementing a state health insurance exchange, while others have resisted. Will the Court decision set exchange efforts in motion in the states that were not already proceeding?

Given the often political nature of this resistance, and the outstanding question of the presidential election and whether a Republican victory could bring about a repeal of PPACA, in many states the delay may continue. With states empowered to opt out of Medicaid expansion, states that have pushed back against exchanges have another front on which to not participate with PPACA.

But states with efforts already under way now have more wind at their backs. The 2014 deadline is becoming imminent, creating an incentive to get moving. And states also face a deadline on January 1, 2013, at which time the federal government will assess whether states have the infrastructure in place to proceed with an exchange. For some states these two deadlines may be enough to begin implementation efforts.

For more insights into state exchanges click here. If you work in healthcare and would like to join Milliman’s State Health Exchange Work Group on LinkedIn, go here.