CMS Administrator and Secretary of the Medicare Trustees Marilyn Tavenner

Q: How has your door been ‘open’ to those worried about Affordable Care Act provisions?

A: A big part of our effort has been working closely with states to begin building new health insurance marketplaces, the Affordable Insurance Exchanges, where Americans will be able to choose private health insurance plans based on price and quality.

Q: When do they go ‘live’?

A: These marketplaces will open in 2014, the same time when insurance companies will no longer be able to discriminate against Americans with a pre-existing condition.

Q: What flexibility is there?

A: States can run exchanges on their own, in collaboration with other states or in a transitional or permanent partnership with our department. Well before the November deadline, 13 states, where a third of Americans live, have committed to establishing an exchange. A state may not, as a consequence of not participating in this expansion, lose federal funding for its existing Medicaid program.

Q: What if a state changes its mind?

A: If a state ultimately decides not to [expand Medicaid eligibility or to run its own exchange], it will not have to pay resources back.