It appears likely that 18 states and the District of Columbia plan to set up their own state-based health insurance exchanges to launch in 2014.
Health insurance premium increases far outpaced the average hike in wages for low- and middle-income workers, while deductibles in small and large firms more than doubled from 2003 to 2011, according to The Commonwealth Fund.
The health care law does not allow states to partly expand their Medicaid programs, administration officials recently announced in an 18-page letter to governors. Health and Human Services Secretary Kathleen Sebelius also has given conditional approval to six states to go ahead with their exchanges.
New details emerged last week on how federal exchanges will operate in states that decline to establish their own exchanges, accompanied by a pledge from the Obama administration that it will strive to allow states to continue their traditional oversight of insurance plans.
Hospitals in the Medicaid program have sharply increased their use of health information technology (IT) in response to about $12 billion in incentive payments available to them between 2011 and 2019 under the economic stimulus law, the Government Accountability Office (GAO) says.
Lawmakers are continuing to look for ways to save money by improving care for "dual eligibles," a costly group of beneficiaries who qualify for both Medicare and Medicaid.