Republican leaders from the House Energy and Commerce Committee called on the Government Accountability Office on Wednesday to examine the role of the Centers for Medicare and Medicaid Services (CMS) in assisting states transitioning from a state-based information technology system (IT) to the federal program.
The letter was signed by full committee Chairman Fred Upton (R-MI), Health Subcommittee Chairman Joseph Pitts (R-PA), Oversight and Investigations Subcommittee Chairman Tim Murphy (R-PA) and Communications and Technology Subcommittee Chairman Greg Walden (R-OR).
The request follows concern from the committee leaders that, with approximately $5.5 billion in Obamacare grants already awarded to states, states may put taxpayer dollars at risk by being unable to financially sustain their marketplace IT systems.
“These grant awards totaled approximately $5.5 billion at the end of December 2014, with 83 percent of the funds awarded to states that chose to establish their own marketplaces (i.e., state-based marketplaces),” the letter said. “Yet, roll-out and operation of the marketplaces has been problematic for many of these states, as websites froze or crashed, and other technical problems hindered or prevented consumers’ ability to enroll in healthcare. Consequently, a number of states that struggled with their IT implementation are now using the federal IT platform to allow consumers to enroll. To date, four states — Hawaii, Nevada, New Mexico, and Oregon — have chosen this course for one or more years of marketplace coverage.
“The ACA required state-based marketplaces to be self-sustaining beginning January 1, 2015, and prohibited CMS from awarding exchange grants after December 31, 2014. In the absence of federal funds to support state marketplace operations, questions remain as to whether states will be able to financially sustain their marketplace IT systems. Given the significant federal investment in these state marketplaces, and the unavailability of federal grant funds to support state marketplace operations, we are requesting that the Government Accountability Office examine and report on this issue.”
The letter seeks answers to three questions, including what assistance CMS has provided in guiding states choosing to transition to a different marketplace IT platform, what assistance from CMS has been provided in guiding states’ efforts to financially self-sustain any future marketplace IT system’s development and operations, and what role CMS has either taken or planned to oversee and monitor the operation and performance of states’ marketplaces in the absence of federal grant funds.