1:50 pm CST - March 02, 2012
Posted under The Scoop
By Jim Cardle
Texas Insider Report: WASHINGTON, D.C. – Every state has received a $1 million planning grant. 34 states & the District of Columbia have received a total of more than $600 million from the Dept. of Health & Human Services to build their own state health insurance exchanges. But when it comes to implementing the state-run efforts demanded in the controversial 2010 federal health law many Americans still refer to today as “ObamaCare”, many mostly-GOP governors are balking.
It’s hard to find a governor who doesn’t agree its a good idea to create an organized marketplace to help consumers and small businesses shop for health insurance.
However, as with most federal government programs, taking the bait of federal funding in order to cover the costs of the “optional” program has tremendous persuasion over a governor’s decision.
By opting out of the “optional program” of building their state’s own exchange, in most cases due to cost & funding implications, they also hand over control of the project to the federal government — something no governor wants to do.
By opting-in to the “optional program”, they must assume responsibility for the costs & funding obligations – and to many governors in these economic times, the dilemna is rooted in a simple, yet complex decision based upon the facts of their current economic budget projections, or constraints.
So instead of taking a hard line on the issue, a handful of governors have recently carved out a middle ground. They’re putting off a decision until June when the U.S. Supreme Court is expected to decide whether the health law is constitutional.
According to news reports compiled by the Center for Budget & Policy Priorities, those states waiting are:
- South Dakota
- Virginia, and
Nebraska Governor Dave Heineman, a Republican, is a good example. In his January state of the state speech he declared:
“Because it is the current law, our state is moving forward with the planning and designing of a state health insurance exchange.”
The big question is whether states that wait for the high court’s decision will be able to build an online insurance marketplace in time to meet federal deadlines.
“It’s hard to tell,” says Joy Johnson Wilson, health policy director for the National Conference of State Legislatures. “There’s a lot going on behind the scenes.”
Wilson and others report that even in states where governors are holding off, a lot of work already has been done using federal grant money.
They’re also intended to make it easier for low-income people to apply for Medicaid and help business owners and moderate-income individuals apply for federal tax credits. States must have simplified insurance offerings and a standardized application form — plus a consumer-friendly online presentation — ready to pass muster with federal regulators by January 1, 2013.
If they don’t, the federal government may decide to step in.
But the U.S. Department of Health and Human Services has recently proposed a couple of other options. Although details are not yet available, the agency has said states can partner with the federal government to build an exchange or take over a federally-run exchange in 2015. In both cases, federal money would be available for states.
Of the dozen states that are postponing a decision, five — Florida, Georgia, Kansas, South Dakota & Texas — also have failed to apply for federal money to build an exchange.
At least 11 states and D.C. have fully embraced health insurance exchanges with laws or by executive order:
- Rhode Island
- Washington, and
- West Virginia