Battle for au­thor­ity

GOP gov­er­nors want in­surance ex­change con­trol

Modern Healthcare - - The Week In Healthcare - Re­becca Vesely

Repub­li­can gov­er­nors are tak­ing Pres­i­dent Barack Obama up on his of­fer made dur­ing the State of the Union ad­dress last month to sug­gest im­prove­ments to the health­care re­form law. They’re ask­ing for more lee­way in im­ple­men­ta­tion, and they say they won’t help if they don’t get their way.

In con­junc­tion with pend­ing law­suits seek­ing to re­peal the law out­right, some gov­er­nors want con­ces­sions on crit­i­cal as­pects of the law.

Twenty-one Repub­li­can gov­er­nors sent a letter to HHS Sec­re­tary Kath­leen Se­be­lius on Feb. 7 ask­ing for six changes to the rules on state-level health in­surance ex­changes. States are re­quired to have these ex­changes—where in­di­vid­u­als and small busi­nesses can pur­chase health ben­e­fits—up and run­ning by Jan­uary 2014. If the states do not cre­ate and run the ex­changes, HHS will do it for them.

The Repub­li­can gov­er­nors said in the letter they want com­plete au­thor­ity to de­cide which in­sur­ers are able to of­fer prod­ucts on the ex­changes. They also want to be able to move Med­i­caid ben­e­fi­cia­ries into the ex­changes with­out prior fed­eral ap­proval. In ad­di­tion, the gov­er­nors re­quested fed­eral funds to help them de­ter­mine which res­i­dents qual­ify for the ex­changes and which con­sumers can get sub­si­dies to help them af­ford cov­er­age.

The law is “se­ri­ously flawed, fa­vors de­pen­dency over per­sonal re­spon­si­bil­ity, and will ul­ti­mately de­stroy the pri­vate in­surance mar­ket,” the gov­er­nors wrote in the letter. “Be­cause of this, we do not wish to be the fed­eral gov­ern­ment’s agents in this pol­icy in its present form.”

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