It is common knowledge that many U.S. states are unwilling to launch their health insurance exchanges until the Supreme Court gives its final ruling on the constitutionality of Affordable Care Act of 2010 and its individual mandate clause. If the states are unable to submit viable health exchange plans by January 1, 2013, the federal government will step in to establish their own exchanges in the defaulting states.

With increasing number of states backing out of HIX establishment plans the pressure, of setting up federal exchanges in these states, is growing on the federal government. The common questions doing the rounds in the U.S. healthcare industry is that – is the federal government well prepared to establish their own exchanges by the designated HIX deadline of January 2014?

The federal exchanges will operate similar to the proposed state health insurance exchange models – a one-stop, web based platform where individuals and small businesses would be able to compare health plans from different vendors based on different parameters such as quality of medical service, price and coverage options.

The exchanges will also provide consumers with the facilities of checking eligibility online for Medicaid, small business tax credits, federal subsidies etc. The exchanges – established by state or federal government - will need to maintain a large pool of consumer specific income, residency, and financial status and employment data.

It would be hard to evaluate the preparation and readiness status of federal government in setting up fully functional insurance exchanges by 2014, as there is not much data available on them to make a rough estimate.

Setting up insurance exchanges will require a lot of deliberation on the structural, technological, administrative, data security and financial aspects and the task may prove equally daunting for federal government as it is for the state governments.

While most of the U.S. states have taken Level 1 health insurance exchange establishment grants from the national government, some states such as Florida, Louisiana and Alaska have openly declared that they would not be setting up their own exchanges. Other states, who even though have applied for Level 2 establishment grants, may still not be able to meet the January 2014 deadline. For all such states, the federal government will have to step in and launch their own exchange websites if the status quo remains the same over the next year.

Apart from setting up HIPPA and other security standards compliant online exchange, the national exchanges will need to be interlinked with other exchanges operating around the U.S., to maintain the integrity of data and establish connectivity. The consumer data for all Americans will need to be collated, maintained and regularly updated to ensure accuracy in any analysis.

The federal government is facing formidable challenges as far as setting up fully functional health insurance exchanges are concerned. Although there is not much data available on the federal exchanges progress as of now, one can only surmise that when the deadline approaches, the federal government will be able to deliver on their promise of fully operative insurance exchanges.