Six states have said...

...they will not enforce provisions in the ACA related to the exchanges and market reforms. Texas, Arizona, Alabama, Missouri, Oklahoma and Wyoming have notified CMS that they will not be policing the law, The Texas Tribune reported Aug. 7. By federal law, states must enforce the provisions unless they notify the feds that they cannot or will not do so. If a state does not enforce the reforms, CMS will take on the responsibility, according to the article. A Texas Department of Insurance spokesperson said his agency cannot enforce the ACA regulations because it is not authorized to do so.

"We can't act on anything that doesn't exist in state law," John Greeley told the Tribune. The federal government will have to review insurance forms and respond to any consumer complaints in these states, said Kevin Lucia, J.D., an assistant research professor at Georgetown University Health Policy Institute’s Center on Health Insurance Reforms. Those duties are “typically reserved for state insurance departments,” he said, according to the article.