States Ponder Creation of Health Exchanges

Even before the Supreme Court rules on the health care law, states are debating how far they should go to set up the health care exchanges that the law would require them to create. Most states have started laying the groundwork for the exchanges, but others are banking on the nation’s high court striking down the law instead.

Florida Governor Rick Scott, a former hospital executive, is one of the chief opponents of the law. He told a Tampa radio station there is no point in setting up the exchanges. “We believe it’s unconstitutional,” he said, according to National Public Radio.

“All it’s going to do is raise the cost of health care in this country,” he said. “It’s not good for you. It’s not good for you as a patient. It’s not good for you as a taxpayer. It’s not good for you as a businessperson. That raises your cost and makes you lose jobs.”

In Michigan, the question of setting up an exchange pits Republicans in the state House against the administration of Republican Governor Rick Snyder, reports the Lansing bureau of The Associated Press.

House Republicans argue that it makes more sense to wait for a decision by the Supreme Court, expected by June, than to start work on complying with a law that might ultimately be struck down. But Steve Hilfinger, Snyder’s point person on setting up the exchanges, notes other states have already begun work. “Michigan, on the other hand,” he says, “cannot and has now fallen behind many of these states in our planning.”

In New Mexico, the Republican doctor in charge of making sure the state complied with the federal law resigned last week, writes The (Santa Fe) New Mexican. Dr. Dan Derksen told the paper he lost the internal battle over how to roll out the law. New Mexico has the second-highest rate of uninsured residents of any state, trailing only Texas.

Although many Republican governors, as Stateline reported earlier, used their state of the state speeches to attack the federal law, the divide among states is not strictly partisan.

Arizona Governor Jan Brewer, who has had a frosty relationship with President Barack Obama, is nonetheless setting up a health insurance exchange. “Brewer’s advisers,” explains The Arizona Republic, “see it as a practical way to put Arizona’s imprint on part of the health law that, if upheld, will have far-ranging impact on consumers, businesses and the economy.”

Washington Governor Christine Gregoire, a Democrat, approved legislation Friday (March 26) calling for the creation of an exchange there, but vetoed a provision that would have automatically closed down the exchange if it lost money, reports the AP.

Meanwhile, New York Governor Andrew Cuomo, already mentioned as a potential Democratic presidential candidate in 2016, says he may have to drop plans for an exchange, because the Republican-controlled Senate objects to it.

“I’m working very hard to make it part of the budget,” Cuomo said Saturday, according to the (Albany) Times-Union. “The Senate is resistant to putting it in the budget. I said there are a number of options to accomplish setting up a health exchange.”