DES MOINES The diagnosis for action by the Iowa Legislature on health care issues this session is inconclusive.

Iowa enters the week facing a mid-February deadline for submitting a blueprint on how state officials envision operating a health insurance exchange in partnership with the federal government. Exchanges are online sites where small businesses and people who arent insured at work will be able to shop for health insurance starting in 2014.

As envisioned under President Obamas Patient Protection Affordable Care Act, individuals and small businesses would use the new framework to shop for health insurance among competing private plans and obtain federal subsidies to help defray the cost. States are to notify the federal government by Friday if they want to help with selected tasks, such as consumer assistance and the supervision of health plans, in partnership with the federal government.

Gov. Terry Branstad has notified federal officials that Iowa prefers a state-federal partnership and Michael Bousselot, Branstads policy adviser for health issues, said Iowa officials will submit a proposed blueprint to be certified by March 1 that will maintain and retain current state management and regulatory responsibilities of Iowas insurance market as well as control of the Medicaid eligibility system that connects with the federal government portal.

The federal government will handle the exchange website and information technology platform that interfaces with the federal portal and the Internal Revenue Service data base needed to provide users with real-time income and tax information and enroll them into a qualified health insurance plan or Medicaid program with access to eligible tax credits, he said.

Were going to maintain control of certain areas, and the federal government will run certain things, Bousselot said. Were going to maintain and do the things that basically the state of Iowa has done for a long time: regulate insurance and regulate the eligibility and intake of new people into our Medicaid rolls. What the federal government is going to do is kind of the stuff that the state of Iowa would have a tough time having ready by Oct. 1.

Open enrollment for exchange plans begins Oct. 1 for coverage starting on Jan. 1, 2014, when most Americans will be required to have insurance.

Last month, the U.S. Department of Health and Human Services announced it had given Iowa more than $6.8 million in federal money to help build its new health insurance exchange. This was to be used to conduct insurance market research and analysis. The state Department of Public Health can use the money to determine what financial resources are needed for individuals, small businesses, coverage appeals and complaints.

Sen. Jack Hatch, co-chairman of the House-Senate health and human services budget subcommittee, disagreed with Branstads decision to proceed with a partnership rather than a state-run exchange. Hatch, a Des Moines Democrat who is possibly the legislatures top expert on health-care policy and is weighing a bid for governor in 2014, also has been critical of the governor for not providing state lawmakers with information on the proposed exchange.

House Speaker Kraig Paulsen, R-Hiawatha, said he believes the governors decision to pursue a federal-state partnership does not require any legislation, and he does not anticipate debating exchange legislation this session.

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Health care bills face shaky prognosis with Iowa lawmakers