Federal Agency To Enforce Obamacare In Four States Refusing Implementation

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At least four states won’t enforce new sweeping insurance market reforms rolling out next year with the health law — leaving federal health officials in Washington to pick up the slack, yet another wrinkle in Obamacare implementation.

Insurance regulation is a huge responsibility that’s been closely guarded by the states. That’s why the Obama administration and those closely watching the rollout of Obamacare believe that even states that have sworn off the law’s coverage expansions will still enforce its new measures — including new benefit mandates, cost-sharing guidelines and rules on how insurers rate customers — to retain control over their health insurance markets.

But the feds will be overseeing the health care law in Missouri, Oklahoma, Texas and Wyoming after those states told HHS they couldn’t or wouldn’t implement the new rules.

“We are enforcing because Oklahoma notified … that it has not enacted legislation to enforce or that it is otherwise not enforcing the Affordable Care Act market reform provisions,” Gary Cohen, director of the federal Center for Consumer Information and Insurance Oversight, wrote to the Oklahoma Insurance Department on Friday. Officials in Missouri, Texas and Wyoming received similar letters, an agency spokeswoman said.

The enforcement letters come a little more than a month after a Commonwealth Fund report found just 11 states and Washington had started to adjust state laws to prepare for seven major ACA insurance reforms taking effect in 2014.

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