As for the federal government's own plans to craft back-up exchanges for states that can't do it, Connolly says "we don't know for certain what progress has been made on the federal level because it has been somewhat quiet about that. There is a ton to be done on the exchanges in a very short period of time."
"I have a suspicion that in the next week or two we will see a flurry of announcements. We will see more regulations being released, more guidance," she says. "There is a certainty in Washington during an election year that from Labor Day to Election Day things just quiet down, and so it's the natural flow of things in this town that post-election you get a flurry of activity. If we were to wait until the end of November, we will have a clearer picture of where we stand."
Paul Keckley, executive director of the Deloitte Center for Health Solutions, says a federal backstop for exchanges "may not have all the capabilities in place to manage enrollment and eligibility and capture people, and they have to have that capability in place by Oct. 1 2013."
"The federal government has a lot of catching up to do," he says. "The reality is 32 to 35 states will end up in a federal partnership and that is many more than originally thought. We may have seven or eight states that simply say ‘I want the federal government to do it for me.' The federal government is going to be ramping up its efforts to get ready because these exchange blueprints are going to come in and they are going to realize they have a lot to do for the states."