The headlines lately are full of stories about the touchy politics of health reform or the legal challenges in the courts. So from time to time it's useful to check on how implementation is actually going in the states, even states pursuing legal challenges. If you poke your head outside of the Beltway (or talk with those intrepid voyagers who do), you’ll see that -- while their stories might not be grabbing headlines at the moment -- the on-the-ground implementation efforts are by and large moving ahead quite nicely.
A few days ago at the Alliance for Health Reform event, “Designing a Marketplace that Works: Steps to Affordable Coverage,” Joel Ario (from HHS) and Michael McRaith (from the Illinois Insurance Department), amongst others, surveyed the current status of exchange development. Their message, echoing what you’ve heard from anyone from NAIC since the insurance commissioners began tackling MLR (medical loss ratio) during the last couple of months, is that January 1, 2014 is the shortest 3-plus years away you’ve ever seen. But both Ario and McRaith, returning from “the field,” seemed confident that states are on track, that they are focused and in sufficiently high gear to make the deadline to have functioning insurance exchanges.