Many states not ready for healthcare exchanges
A number of states, many of them with GOPteabag governors or legislatures, aren’t ready for this Friday’s deadline to announce how the new healthcare exchanges, created under the Affordable Care Act, will be implemented in their states.
From the NYT today:
DES MOINES — The days since President Obama won re-election have been marked by tension and angst in Republican-led states like Iowa, where Gov. Terry Branstad has waited until the last minute to decide whether to create a crucial tool for people to get medical coverage under Mr. Obama’s health care law.
‘There has been a total blackout of information,’ said State Senator Jack Hatch, a Democrat who vented his frustration at a news conference here this week. ‘We’re behind schedule, we’re at a disadvantage, and I don’t know what our governor’s plan is to reposition Iowa.’
States are supposed to tell the Obama administration by Friday whether they want to create their own health insurance exchange — a deadline that many had bet might never come to pass, choosing to sit on their hands for months in the hope that Mitt Romney would win the presidency and the health care law would be repealed.
Surprising, isn’t it? No one could have predicted that GOPteabag governors might care more about their opposition to the president than the welfare of their own citizens.
Despite the unhappiness, there are indications that some Republican governors may be softening their opposition to the law. Gov. Rick Scott of Florida, a Republican who had been one of its toughest critics, signaled this week that he would be open to compromising.
‘The election is over, and President Obama won,’ Mr. Scott told The Associated Press. ‘If I can get to yes, I want to get to yes.’
And Governor McDonnell of Virginia — like Florida, a state Mr. Obama carried — noted that while his state had been the first to file suit seeking to block the law, it would comply with it.
But he said that the complexity of the law, and the lack of details from Washington, meant that ‘my best experts in Virginia, my doctors and others that are advising me on what to do, say they still can’t make a prudent call between a state or federal exchange because we don’t have all the answers.’
Others are facing intense, sometimes conflicting pressures from state legislators and interest groups. In Wisconsin, health care providers and business groups are lobbying Gov. Scott Walker to create a state exchange, while Tea Party groups are warning him not to.
Ah, teabaggers. Gotta love ‘em. Maybe they think that as long as the state doesn’t create the exchange they won’t have to have Obamacare. Brilliant.
Setting up an insurance exchange is no simple task. Among other things, states have to set up a governance board, decide what kinds of health plans to offer through the exchange and build sophisticated information technology systems.
Yeah, how about that. Governing is hard.
Even if Iowa opts for a partnership with the federal government, it will be ‘without a totally clear understanding of who needs to do what,’ said Charles M. Palmer, director of the state’s Department of Human Services.
Walking down a hallway during the Republican governors meeting on Wednesday, Mr. Branstad said that Iowa was working on its letter to send the administration by the Friday deadline, but that officials did not feel they had gotten all the information they needed from the federal government.
‘There’s a whole lot of questions we have,’ he said. ‘We have a whole lot of questions.’
That’s some great leadership there, isn’t it?