08 February 2011

Republican govs demand flexibility to run insurance exchanges

Republican govs demand flexibility to run insurance exchanges ; Many of the nation’s Republican governors are asking the Obama Administration for generous flexibility to implement and oversee new state-run health insurance exchanges required in the healthcare reform law.

Noting their intense opposition to the healthcare overhaul, 21 Republican recommended six major improvements for state-run exchanges that would give the states more decision power. Under healthcare reform, the Department of Health and Human Services can run a state’s exchange if it fails to set one up by 2014.

In a Wall Street Journal op-ed Monday morning, Indiana Gov. Mitch Daniels – a rumored Republican candidate in the 2012 presidential election – said states would prefer to implement the reform law on their own terms if legal challenges and repeal efforts fail.

“If there’s to be a train wreck, we governors would rather be spectators than conductors,” Daniels wrote. “But if the federal government is willing to reroute the train to a different, more productive track, we are here to help.”

In the letter, the governors asked HHS to: Provide states with “complete flexibility” on operating the exchange, including the choice of which insurers can offer products; waive mandates and allow states to choose benefit rules; waive provisions discriminating against consumer-driven health plans, like health savings accounts; allow the flexibility to move non-disabled Medicaid beneficiaries into exchanges; deliver a plan for verifying incomes and subsidy amounts for exchange participants; and commission a “new and objective" assessment of how many people will enroll in exchanges and Medicaid as a result of the reform law.

The letter was much less an endorsement of a key reform law provision than it was a rebuke of what the governors described as federal overreach.

“We wish states had been given more opportunity to provide input when the [law] was being drafted,” the governors wrote. “We believe in its current form the law will force our health care system down a path sure to lead to higher costs and the disruption or discontinuation of millions of Americans’ insurance plans.”

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