Don't hold your breath waiting for anyone at Health and Human Services to call you back.

That's the moral of the story Kathy Kliebert, secretary of the Louisiana Department of Health and Hospitals, told at a House subcommittee hearing on state implementation of the Patient Protection and Affordable Care Act.

Getting a response from HHS can take three to four months, Kliebert said, which has run up implementation costs.

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"We cannot afford to wait months for these answers," Kliebert said.

Kliebert cited efforts to get HHS officials to help state Medicaid programs adopt a new income eligibility litmus test – a Modified Adjusted Gross Income standard – as an example of a result of the delays.

Most states have to revamp their systems to shift to the new standard.

Back in March, the feds promised they would develop a new solution that would be free to the states. Instead, Kliebert added, HHS officials backtracked in June, telling state officials they were on their own.

That shift is forcing Louisiana to spend about $750,000 on additional contractor work, Kliebert said.

Kliebert also questioned how well HHS has trained the call center workers supporting exchanges in states like Louisiana where the feds are running things.

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Allison Bell

Allison Bell, a senior reporter at ThinkAdvisor and BenefitsPRO, previously was an associate editor at National Underwriter Life & Health. She has a bachelor's degree in economics from Washington University in St. Louis and a master's degree in journalism from the Medill School of Journalism at Northwestern University. She can be reached through X at @Think_Allison.