States' choices set up national experiment with President Obama's health care overhaul
"There is a sense of irony that it's the more conservative states" yielding to federal control, said Sandy Praeger, the Republican insurance commissioner in Kansas, a state declining to run its own exchange. First, she said, the law's opponents "put their money on the Supreme Court, then on the election. Now that it's a reality, we may see some movement."
They're not budging in Austin. "Texas is not interested in being a subcontractor to Obamacare," said Lucy Nashed, spokeswoman for Gov. Rick Perry, who remains opposed to mandates in the law.
In Kansas, Praeger supported a state-run exchange, but lost the political struggle to Gov. Sam Brownback. She says Kansans will be closely watching what happens in neighboring Colorado, where the state will run the market. She doubts that consumers in her state would relish dealing with a call center on the other side of the country. The federal exchange may have some local window-dressing but it's expected to function as a national program.
Christine Ferguson, director of the Rhode Island Health Benefits Exchange, says she expects to see a big shift to state control in the next few years. "Many of the states have just run out of time for a variety of reasons," said Ferguson. "I'd be surprised if in the longer run every state didn't want to have its own approach."
In some ways, the federal government has a head start on the states. It already operates the Medicare Plan Finder for health insurance and prescription plans that serve seniors, and the Federal Employees Health Benefits Program. Both have many of the features of the new insurance markets.
Administration officials are keeping mum about what the new federal exchange will look like, except that it will open on time and people in all 50 states will have the coverage they're entitled to by law.
Joel Ario, who oversaw planning for the health exchanges in the Obama administration, says "there's a rich dialogue going on" as to what the online shopping experience should look like. "To create a website like Amazon is a very complicated exercise," said Ario, now a consultant with Manatt Health Solutions.
He thinks consumers should be able to get one dollar figure for each plan that totals up all their expected costs for the year, including premiums, deductibles and copayments. Otherwise, scrolling through pages of insurance jargon online will be a sure turn-off.
- Boy Scouts open membership to all boys,...
- Defending the Faith: A case for the...
- One third of millenials regret going to college
- Abercrombie & Fitch CEO posts statement on...
- Stories behind viral Oklahoma tragedy photos...
- Facts about the Boy Scouts of America
- Brave woman tried to reason with London...
- Why $1 billion doesn't mean what it used to...
- Defending the Faith: A case for the... 54
- Journalists criticize Obama... 38
- Boy Scouts open membership to all boys,... 36
- Associated Press CEO calls records... 23
- IRS official Lerner invokes Fifth... 22
- Former IRS chief to Congress: Can't say... 21
- More Obama aides knew IRS targeted... 19
- Supreme Court to weigh in on... 17