A new report from the General Accountability Office assesses the readiness of federally facilitated health insurance exchanges to be operational by Oct. 1, 2013, to support open enrollment for insurance coverage that starts in January 2014.

The Centers for Medicare and Medicaid Service is implementing exchanges in 34 states that have refused to do so themselves, although 15 of the balking states are expected to handle certain exchange functions, according to GAO, a congressional watchdog agency. The bottom line: “Whether these efforts will assure the timely and smooth implementation of the exchanges by October 2013 cannot yet be determined,” the GAO concludes.

Some activities supporting establishment of the federal exchanges remain behind schedule, including eligibility and enrollment, plan management, and consumer assistance. “To support consumer eligibility determinations, for example, CMS is developing a data hub that will provide electronic, near real-time access to federal data, as well as provide access to state and third party data sources needed to verify consumer eligibility information,” GAO explains in the report. “While CMS has met project schedules, several critical tasks, such as final testing with federal and state partners, remain to be completed.”

CMS also has not completed certification of qualified health plans and inclusion of the plans’ information on exchange Web sites. Funding awards for “Navigators” to assist consumers in using the exchanges to select coverage have been delayed for two months, which has delayed training. “Much progress has been made, but much remains to be accomplished within a relatively short amount of time,” the report concludes. “CMS’s timelines provide a roadmap to completion; however, factors such as the still-evolving scope of CMS’s required activities in each state and the many activities yet to be performed--some close to the start of enrollment--suggest a potential for challenges going forward.”

The GAO report is available here. Also available is a new report on the status of the Small Business Health Options Program.

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