States, Feds Battle Over Health Law
Today is the deadline for states to tell the federal government if they will set up health insurance exchanges. The online marketplaces are a part of the health care law some call “Obamacare.”
The easiest way to understand health insurance exchanges is to think of them as a travel comparison website. Except instead of selecting a class of airline seat, you would choose from things like deductibles and levels of coverage. The exchanges will also determine what if any subsidies for which you might qualify. Governor Perry spokesperson Lucy Nashed says Texas has no intention of setting up a state health insurance exchange.
“The federal government has set up exactly how the exchange is set up and run, so this notion that Texas would have any kind of autonomy is an illusion,” said Nashed. “We will not be party to socializing health care in our state. That’s just not something we’re looking at.”
Thirteen other states have taken that same position, according to the Kaiser Health Foundation. But the health care law was written so that the federal government will establish exchanges for those states instead. Garnet Coleman is a Democratic State Representative from Houston.
“Governor Perry’s trying to make a point,” Coleman said. “But that’s why I say one monkey don’t stop no show, because the people will still get what the law says they should get, because they are citizens of the United States of America.”
But from a consumer standpoint, will a federally run health insurance exchange be just like one run by the state? For the most part yes, according to the first person to helm the federal government’s Office of Health Insurance Exchanges.
“The average consumer shouldn’t notice any difference,” said Joel Ario, a health industry consultant in New York City. “The difference is really who’s in charge. Under the federal exchange, the federal government is picking the insurers that are going to be in that exchange, and setting the rules around exactly how they’re going participate, what kind of products are specifically going to be offered.”
A federally-run exchange might have trouble qualifying consumers for state run programs. Like what if you go on a federally-run exchange website, and it says you are eligible for Medicaid? Would you have to reapply through the state?
“Theoretically that shouldn’t happen,” said Heather Howard, head of the State Health Reform Assistance Network at Princeton University. “The exchange should hopefully connect with the state Medicaid program and get that person enrolled. There is a lot operationally that needs to be done in the next year, and those are the issues the federal government will be working through.”
States will have to work through them as well. The exchanges are supposed to start enrolling people next October. By January 2014, the health care law will require that almost all Americans have health insurance.