December 14, 2012-That’s the deadline that was given to governors to decide whether or not they will create their own state healthcare exchange program or leave it to the Department of Health and Human Services to step in and implement the exchange as part of the federal program. Even though the Affordable Care Act (ACA) aka “Obamacare” does not go into effect until 2014, governors are required to make the decision two years ahead of implementation. The purpose of the health care exchanges is to assist individuals and small businesses with picking health insurance options. The exchanges will help them determine whether they qualify for government subsidies or Medicaid, feature cost calculators to compare different levels of insurance coverage, and feature tools to allow individuals to view whether their current doctor or hospital participates in a particular plan. In fact, the exchanges will begin to enroll eligible families beginning October 1, 2013 and provide coverage beginning January 1, 2014.
To date, twenty states have already opted out of creating their own health care exchange. Those states include: New Jersey, South Carolina, Louisiana, Wisconsin, Ohio, Maine, Alabama, Alaska, Arizona, Georgia, Pennsylvania, Kansas, Nebraska, New Hampshire, North Dakota, Oklahoma, South Dakota, Tennessee, Texas, and Wyoming. Most recently, eleven Republican governors including Florida Governor Rick Scott, Louisiana Governor Bobby Jindal, and Arizona Governor Jan Brewer wrote a letter to President Obama requesting a meeting to discuss federal healthcare overhaul including Medicaid expansion and setting up healthcare exchanges in states with limited funds. Within the letter, they asked the President to work with them and possibly allow them to determine their state’s own Medicaid eligibility levels and still receive all of the federal funds allocated for those states who establish the exchanges before the deadline.
Nineteen states have agreed to create their own state based health care exchange including states with Republican governors like Iowa, Mississippi, Idaho, New Mexico, and Nevada. In Montana, Indiana, and Missouri, the federal government will more than likely have to step in and create the health exchange in those states since their governors either rejected the idea or could not agree on whether to establish the exchange. Conversely, in Utah, their governor has asked President Obama to approve an already existing state exchange program as their ACA required health exchange program. Six states have agreed to partner with the federal government to create their health care exchange including Arkansas, Delaware, Illinois, North Carolina, and West Virginia.
Recently, all eyes were on Florida and Virginia as their governors mulled over whether or not they would implement a state exchange program. Florida Governor Rick Scott decided not to implement the state health exchange with the backing of Republicans in the Florida legislature. In fact, the Florida Senate recently launched an anti-Obamacare website. Virginia Governor Bob McDonnell also decided not to implement a state healthcare exchange. Regardless of the governors’ decisions, the implementation of the health care exchange programs will surely be a daunting and challenging task for President Obama’s administration.