This report from the General Accountability Office (GAO) describes the progress that the Centers for Medicare & Medicaid Services (CMS) has made in establishing federally-facilitated health insurance exchanges (FFE) under the Patient Protection and Affordable Care Act.  Since only 16 states and the District of Columbia have chosen to establish state-based exchanges, the challenge of establishing federally-facilitated exchanges in the remaining 34 states by the October 1, 2013 deadline is enormous.

CMS is developing a data hub that will provide electronic, near real-time access to federal data, as well as access to state and third party data sources needed to verify consumer-eligibility information.  While CMS has met project schedules, several critical tasks, such as final testing with federal and state partners, remain to be completed.  For plan management, CMS must review and certify qualified health plans (QHPs) that will be offered in the FFEs.  Although the system to submit applications for QHP certification is operational,  several key tasks regarding plan management, including certification of QHPs and inclusion of QHP information on the exchange websites, remain to be completed.  In the case of consumer  assistance, funding awards for  navigators, a key consumer assistance program, have been delayed by about two months, which has delayed training and other activities.

CMS is also depending on 15 of the 34 states to implement some FFE functions, but many of these state activities remained to be completed and some are behind schedule.

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