State Health Insurance Exchange progress update 2012

January 1, 2014 is the federal designated timeline, from when the State Exchanges are required to become operative. A 2012 interactive Associated Press report together with Urban Institute’s survey, however paints a dismal picture of the States HIX readiness status.
The report establishes that most of the U.S. States are showing uneven progress and are lagging behind in their schedule for setting up fully operational State Exchanges – the web based one stop marketplaces for individuals to search, compare and buy health insurance.
If the Supreme Court upholds the PPACA and the controversial Individual Mandate clause as constitutional in its mid-year ruling, then the States would have too little time remaining to get their Exchanges up and running. All the U.S. states need to submit their HIX plans by January 1, 2013 for federal approval. If the States are not ready by the established timeline, the federal government will step in and take control of the State Exchanges, a move that can cost States.
While 13 U.S. States that include names like California, Washington, Oregon and District of Columbia, have adopted a plan to set up Exchanges, as many as 20 states which include Texas, Georgia, Ohio, are making little or no progress on their Exchange plans. Interestingly, these 20 states account for the biggest number of the uninsured Americans, around 21 million. 
If states like Texas, Georgia, Florida and Ohio are successful in setting up fully-functional HIX by 2014 that alone will add over 7 million Americans to the insurance rolls and will reduce the States’ annual expenditure on charity medical care by $10.7 billion. 
From among the 20 states whose HIX implementation plans are yet unclear, four states – Louisiana, Florida, Arkansas and New Hampshire - have shown no considerable progress at all and Louisiana, New Hampshire and Florida have returned their HIX establishment grants to the federal government.
While states like New York, Alabama, Virginia, Maine feature among the 17 states who have made a headway in their HIX plans, it is still hard to say how many of these states will be able to deliver on the January 2014 deadline.
Associated Press has categorized States as making ‘Substantial progress’ if their governors or legislative assemblies have made a commitment towards setting up exchanges or have accepted the federal HIX establishment grant. This group of 17 states account for only 1/3 of the number of uninsured Americans – around 16 million people.
Any inferences drawn at this stage on the U.S. states that may be able to deliver on the 2014 deadline or who may be unable to, are sketchy at best. However, one fact remains that if the current scenario of HIX unpreparedness continues, it will prevent a smooth national level rollout of the ACA Health Insurance Exchanges implementation. The result may be a disproportionate insurance patchwork of sorts where some states may report significant number of insured citizens, while their neighboring states may feature least number of uninsured Americans.