A State can chose to build its own Exchange or default to the Federal government.
For those States that choose to build an Exchange, Colorado being one of them, they must begin enrolling consumers and employees in Qualified Health Plans (QHPs) starting October, 2013. The State Exchange must also demonstrate to Health and Human Services (HHS), no later than January 1, 2013, that it will be ready by October of that year.
This gives an Exchange little time to meet all the requirements outlined in the 641 page set of rules published by HHS.
Statereforum.org, an online network tracking health reform implementation, estimates Colorado has completed 11% of the required tasks. This percentage is better than most States.
The Colorado legislature established an Exchange Board (SB 11-200) and the Governor and legislature have appointed its members (see the Colorado Exchange website, getcoveredco.org to read the biographies of each member). The Board, in turn, hired an Executive Director and approved a series of advisory groups to obtain community input on Exchange development and implementation.
The Board makes its decisions in open meetings after receiving feedback from consumers and interested parties. Some of the decisions already made include:
But the Board still has a number of key decisions to make and reaching consensus may not always be fast or easy.
The Board must still determine:
The Exchange staff, in turn, must implement the Board’s decisions, select vendors as appropriate to perform certain tasks, create the Exchange website, establish electronic interfaces with employers, carriers and State agencies and establish certain administrative functions required for the Exchange to operate in accordance with Federal law.
This is a daunting task; the Colorado Exchange continues to make excellent progress but there is still much to do and little time to do it.