Health insurance exchanges: Why do today what you can put off until tomorrow?

By , Posted on 11 November 2012

I am a reformed procrastinator of epic proportions. Back in the day, I had to switch dentists twice because I rescheduled so many appointments it became embarrassing.

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The first office manager started being hostile to me, which I deserved, but it's possible that as the relationship deteriorated I said some passive-aggressive things that could be interpreted as somewhat insulting. The second scheduler was too sweet to be snarky, but her "I'm really disappointed in you" tone was just unbearable. I just couldn't deal with all the drama! What I realized years later is that it's so much easier to just do what's on your "to do" list than to put it off – whether you like it or not.

Some states, it seems, haven't learned this lesson. States had until Nov. 14 to submit plans for how their health insurance exchanges would work. By September, only 19 had started working on them or agreed to do so in partnership with the federal government, according to the Kaiser Family Foundation.

Health insurance exchanges are online marketplaces aimed at making it easier for uninsured people to find an affordable plan and to determine if they qualify for new federal subsidies. (See: "What's coming in health care reform?")

On Nov. 9, states received an extension. They now have until Dec. 14 to send blueprints to the federal government on how they'll set up and start operating the exchanges by 2014, according to a letter Health and Human Services Secretary Kathleen Sebelius sent to governors. The states that want to partner with the federal government to set up the markets have until Feb. 15. (See: "3 Cs of health reform: coverage, care and cost.")

Some states have already decided they will not build the insurance marketplaces, leaving the entire task to the federal government. The governors of Florida, Virginia and Kansas recently announced they would take this route.  

Health reform was in a precarious position until recently, so it's not surprising that many states did not scramble to get their plans drawn up. Why bother tackling road maps for exchanges if the Supreme Court may find the law unconstitutional? But it didn't. (See: "Health reform sticks: Now what?")

It really was a perfect storm for procrastinators of the political ilk, because there was still the chance that President Obama might not be re-elected. Why worry  about insurance exchanges if health reform might be repealed? Of course, Obama won another term.

An estimated 11 million people are expected to get insurance through the exchanges in 2014, according to the Congressional Budget Office, that is, if they don't procrastinate.

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Des Toups

Des Toups

Managing editor

Des Toups is a writer, editor and expert on insurance, cars and personal finance. He has written extensively about all three for national publications such as MSN and major newspapers such as the Seattle Times. He has been quoted about insurance issues in The New York Times, USA Today and Kiplinger's.


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