GOP Governors Seeking Changes to State-Based Insurance Exchanges
On Monday, a group of 21 Republican governors sent a letter to HHS Secretary Kathleen Sebelius calling for more flexibility in implementing state health insurance exchanges under the federal health reform law, Politico reports.
The letter warned that if certain changes are not made, the governors likely would turn over implementation of the exchanges to the federal government (Kliff, Politico, 2/7).
According to the governors, they want "complete flexibility on operating the exchange, most importantly the freedom to decide which licensed insurers are permitted to offer their products" (Lambert, Reuters, 2/7). The governors also want the ability to:
- Waive federal mandates and allow states to select benefit rules;
- Waive provisions that discriminate against health savings accounts and other consumer-driven health plans;
- Move non-disabled Medicaid beneficiaries into the exchanges;
- Develop a system for verifying incomes and subsidies for exchange participants; and
- Conduct a "new and objective" analysis of how many people will enroll in the exchanges and Medicaid because of the reform law (Millman, "Healthwatch," The Hill, 2/7).
HHS, Administration Respond
In response to the letter, HHS spokesperson Jessica Santillo said that since the reform law was enacted, "HHS has made resources available to the states to both plan and establish exchanges and made clear we will consider different models that fit states' needs." She added, "We look forward to continuing to build a constructive partnership with governors and state leaders" (Politico, 2/7).
However, the Obama administration seems prepared to step in if states do not cooperate. An unidentified administration official said, "[W]e aren't going to allow someone not to get important consumer protections just because he has the misfortune of living in a state that doesn't like the law" (Stein, Huffington Post, 2/7).