The executive directors of the nation’s 12 state-based exchanges tell the Trump administration there is not enough time to make the technical and other changes needed to implement a pending rule on health reimbursement arrangements by the 2020 plan year. In an April 29 letter to HHS, Treasury and the Department of Labor , the exchange officials warn that pushing last-minute changes to the systems can be costly, as well as risky, and would detract from other local efforts to...