The federal government will likely be involved in running the ObamaCare exchange in at least 30 states, 26 of which expressly declined to establish state exchanges. One health-policy expert refers to it as an "administrative nightmare" for the Department of Health and Human Services.
Friday was the deadline for a state to let HHS know if it planned to establish a state exchange. Thus far only 18 states and the District of Columbia are planning on doing so.
As of right now only Utah and Florida remain undecided. Utah may still decide to set up a state exchange, but few expect that Florida will. When asked, a spokesman for Florida Gov. Rick Scott directed IBD to a letter Scott sent last month to HHS Secretary Kathleen Sebelius requesting more information on the exchanges and a meeting with Sebelius. Sebelius has not responded to his letter.
Assuming Florida decides not to set up a state exchange, nearly 200 million people, or 64% of the U.S. population, will reside in a state with either a federal exchange or a partnership exchange. Although many of the people in those states such as those on Medicare or who have employer-based coverage will not be getting insurance through an exchange, millions of others will be.
Enrolling them will likely prove a daunting challenge for the federal government.
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