Chaotic times for states and health insurance exchanges

The past days’ Supreme Court debates on the constitutionality factor of Affordable Care Act and the Individual Mandate clause has once again placed ACA back in the center of health care talks. Speculations are rife in the healthcare industry on whether any sort of conclusions or inferences can be drawn about the future of Affordable Care Act and/or the Individual Mandate from the court arguments.

The uncertainties surrounding the Affordable Care Act has further complicated matters for the U.S. states which have been mandated by the congress to establish online insurance marketplaces called Health Insurance Exchanges (HIX) for individuals and small businesses. The deadline for submitting and getting HIX designs approved by the federal government is January 1, 2013 and the deadline for setting up fully functional exchanges is just a year ahead - in January 2014.

Some states such as Massachusetts and Utah which already have operational state insurance exchanges up and running, are relatively better equipped and well-positioned to align their existing structures in line with the ACA imposed guidelines, by the designated January 2014 deadline. Most of these states which are already on their way to establish these insurance marketplaces, continue to move ahead with their insurance exchanges plans irrespective of whether the Supreme Court deems the ACA law unconstitutional or not.

States, which have not yet begun with their HIX implementation plans and those that are moving ahead at a snail pace, are the ones that are awaiting Supreme Court’s verdict on the Affordable Care Act. In the face of the probability that Supreme Court upholds the Affordable Care Act as constitutional, these states may find it difficult to come up with operative health insurance exchange models.

Whether the ACA gets approved or repealed, the state of the healthcare across the U.S. is likely to continue in a patchwork of sorts with some states offering superior medical care to their residents and other states struggling to provide even the basic insurance to their residents. Citizens’ access to affordable, quality healthcare would continue to depend on the state of residence of an individual - as is the case in present day US. A dismal predicament indeed!