GAO: October HIX deadline is a challenge

As the Centers for Medicare & Medicaid Services (CMS) launches a new website devoted to health insurance exchange, a new report from the General Accountability Office (GAO) assesses the readiness of federally facilitated health insurance exchanges to be operational by Oct. 1 to support open enrollment for insurance coverage that starts in January 2014.

CMS is responsible for implementing exchanges in 34 states that have refused to do so themselves, although 15 of those are expected to manage certain exchange functions, according to GAO. “Whether these efforts will assure the timely and smooth implementation of the exchanges by October 2013 cannot yet be determined,” the GAO concluded.

Activities supporting establishment of the federal exchanges remain behind schedule, including eligibility and enrollment, plan management and consumer assistance. “To support consumer eligibility determinations, for example, CMS is developing a data hub that will provide electronic, near real-time access to federal data, as well as provide access to state and third party data sources needed to verify consumer eligibility information,” the GAO wrote. “While CMS has met project schedules, several critical tasks, such as final testing with federal and state partners, remain to be completed.”

CMS also has not completed certification of qualified health plans and inclusion of the plans’ information on exchange websites. Funding awards for “Navigators” to assist consumers in using the exchanges to select coverage have been delayed for two months, which has delayed training. “Much progress has been made, but much remains to be accomplished within a relatively short amount of time,” the report concluded. “CMS’s timelines provide a roadmap to completion; however, factors such as the still-evolving scope of CMS’s required activities in each state and the many activities yet to be performed--some close to the start of enrollment--suggest a potential for challenges going forward.”

The GAO report is available here.

Beth Walsh,

Editor

Editor Beth earned a bachelor’s degree in journalism and master’s in health communication. She has worked in hospital, academic and publishing settings over the past 20 years. Beth joined TriMed in 2005, as editor of CMIO and Clinical Innovation + Technology. When not covering all things related to health IT, she spends time with her husband and three children.

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