Forum for Innovation

The deadline for states to submit their plan for a Health Insurance Exchange (HIX) is November 16^th—just 10 days after the Presidential election. With many states opting to wait to move forward with a plan until after the election is decided, this “wait and see” approach has created a time crunch. 

With just weeks left to finalize and submit a plan to HHS, states have several options to consider:

• Move Forward with a State-Based Exchange. There is still a brief period of time for states to go through the Design, Development and Implementation (DDI) phases of building an Exchange in order to meet the 2014 deadline. Partnering with a vendor with a flexible, proven HIX solution can significantly reduce the implementation timeframe—from months instead of years. Xerox’s SaaS model allows states to invest in only the services they need, without substantial investment and ongoing maintenance costs for dedicated hardware and infrastructure.
• Develop a State/Federal Partnership. In this model, the state will work with the Federal government to develop the Exchange, but maintain responsibility for and control over decisions related to health plans and insurers on the Exchange. This model allows the state to help assure a more customized experience for consumers in the state.
• Default to the Federally Facilitated Exchange (FFE) Model. It is anticipated that a small number of states may not choose either of the above options. In that case, HHS will establish and fully operate an Exchange on behalf of the state.  

In the conversations we’re having with states, we understand that many expect to defer to either a state/federal partnership or the FFE model in the short-term, and transition to a state-based exchange after some period of time as a more permanent solution. My recommendation for the states planning a transition is to identify a partner that has a proven Exchange solution established in order to enable to faster, low-risk cut-over when the time comes. The timeline and depth for a transition also must be closely considered—as Exchanges must be self-sustaining by 2015, any sort of dramatic change to the model between now and 2015 may impact the ability to meet that deadline.

The time period between now and November 16^th will be an interesting time of interaction between states, their partners, and HHS, with activity really ramping up after the election. The bottom line is that no matter which of the options states choose today, working with a partner with a flexible, established solution may be the simplest path between point A and ultimately providing consumers with access to more affordable healthcare coverage.