California's exchange receives approval from feds

January 04, 2013
Area(s) of Interest: Health Care Reform 

Covered California, the state’s recently named health benefit exchange, has received conditional approval from the federal Department of Health and Human Services, according to a statement released late Thursday.

The approval, which was also granted to six other states, comes as a result of significant progress made on the part of planning entities responsible for establishing state-run or federal partner exchanges across the nation.

Approval is contingent upon the states being able to meet deadlines coming before October 2014, when exchanges will begin pre-enrollment.

“States across the country are working to implement the health care law and build a marketplace that works for their residents,” wrote Kathleen Sebelius, federal secretary of health and human services. “In ten months, consumers in all fifty states will have access to a new marketplace where they will be able to easily purchase affordable, high quality health insurance plans, and today’s guidance will provide the information states need to guide their continued work.”

To date, a total of 20 states have received conditional approval from the federal government.

While California has been a leader in implementation of the Affordable Care Act (ACA), several recent actions taken by Covered California’s Board of Directors have caused considerable concern for the California Medical Association (CMA) and the state’s physician workforce as a whole.

These actions include a flawed system of monitoring network adequacy, a continued favoring of two-tiered networks and failure to address major issues with the law’s “grace period” provision.

These issues, along with several others, have been covered at length in CMA Reform Essentials, a regular publication dedicated to the ACA implementation in California.

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