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Bloomberg BNA: House Committees Seek Information On ACA Insurance Marketplaces

Bloomberg BNA: House Committees Seek Information On ACA Insurance Marketplaces
By Sara Hansard
June 03, 2014

June 3 (BNA) -- House Energy and Commerce Committee Republican leaders asked Health and Human Services Secretary Kathleen Sebelius June 3 for details about how the HHS supervised state-based health insurance marketplaces that have encountered serious technical problems.

The HHS awarded more than $1.3 billion for seven state-based marketplaces under the Affordable Care Act “that have failed or are so flawed that they require substantial modification,” and some states may request additional federal money to fix or build new marketplaces, said the letter from committee Chairman Fred Upton (R-Mich.) and Rep. Tim Murphy (R-Pa.), chairman of the Subcommittee on Oversight and Investigations.

To date the HHS has awarded more than $746 million to marketplaces that have been shut down in Massachusetts, Maryland, Oregon and Nevada, the letter said. Reports indicate that marketplaces in Hawaii, Minnesota and Vermont are also likely to be abandoned or will require costly improvements, it said.

“Further, some states may now request additional federal taxpayer dollars to fix or build new exchanges,” the letter said. States that close their marketplaces and shift consumers to the federally facilitated marketplace run by the HHS may request additional funds, as well, it said.

The letter requested information no later than June 18 on who was responsible for awarding the state marketplace grants; how the awards were made; and how the funding was supervised, among other things.

No SHOP Enrollment Data

Also June 3, House Small Business Committee Chairman Sam Graves (R-Mo.) wrote Centers for Medicare & Medicaid Services Administrator Marilyn Tavenner, requesting information on ACA Small Business Health Options Program (SHOP) enrollments.

Over seven months since the SHOP marketplaces opened, “we still do not have any federal and some state SHOP enrollment data,” the letter said.

Following an earlier request for information about the SHOP marketplaces, Sebelius wrote Graves March 12, saying that the information sought wasn't available but that the HHS expected to have SHOP enrollment data at a later date.

In his June 3 letter, Graves asked for the number of small businesses and employees who have enrolled in SHOP marketplaces; how many have paid their first premiums; and the date by which the federal and state-run SHOPs will be fully operational, among other questions. The letter didn't specify a deadline for replying, but it asked for a date by which the information will be provided.

Unlike the individual marketplaces, in which most people can sign up for coverage only during specified open enrollment periods, the SHOP marketplaces are open year-round for employers with 50 or fewer full-time employees. The SHOP marketplaces are intended to provide small companies with more competition and choice, and qualified employers with the equivalent of fewer than 25 full-time employees must purchase coverage through the SHOP to benefit from temporary tax credits offered under the ACA.

The Obama administration has delayed elements of the SHOP required under the ACA as it struggled to get the problem-plagued individual marketplaces operating so that consumers could get coverage during the first open enrollment period, from October 2013 through March.

A December 2013 release from the House Small Business Committee listed an April 2013 delay of a provision under which employees would have the choice of plans in the SHOP marketplaces, as well as the postponement of SHOP enrollment from Oct. 1, 2013, until the end of November 2013, and delayed online enrollment of the federally managed SHOP marketplace until November 2014. Small businesses have been enrolling using paper forms.