On Monday, a group of 21 Republican governors sent a letter to U.S. Health and Human Services (HHS) Secretary Kathleen Sebelius urging her to make specific improvements to the new health exchanges. In the letter, the governors stated that they may not run their own exchanges unless HHS meets their requests.
The Patient Protection and Affordable Care Act (PPACA) requires health insurance exchanges to be created in every state and to be fully up and running by 2014. If a state does not create its own exchange, HHS will step in and create a federally-run exchange for that state.
Republicans captured a majority of statehouses in last year’s election and now hold the governors’ mansions in 29 states. The letter, signed by 21 of the 29 Republican governors, pushes Secretary Sebelius to make six specific changes to the law. These include:
- Provide states with complete flexibility on operating the exchange—most importantly the freedom to decide which licensed insurers are permitted to offer their products.
- Waive the bill’s costly mandates and grant states the authority to choose benefit rules that meet the specific needs of their citizens.
- Waive the provisions that discriminate against consumer-driven health plans, such as health savings accounts (HSAs).
- Provide blanket discretion to individual states if they chose to move non-disabled Medicaid beneficiaries into the exchanges for their insurance coverage without the need of further HHS approval.
- Deliver a comprehensive plan for verifying incomes and subsidy amounts for exchange participants.
- Commission a new and objective assessment of how many people will end up in the exchanges and on Medicaid in every state as a result of the legislation (including those “offloaded” by employers), and at what potential cost to state governments.
If these changes are not made, the letter says that they are unlikely to operate their own health exchanges and would leave the task to the federal government.
“While we hope for your endorsement, if you do not agree, we will move forward with our own efforts regardless, and HHS should begin making plans to run exchanges under its own auspices,” the letter states.
To read the complete letter, click here.
John Prible (john.prible@iiaba.net) is Big “I” vice president for federal government affairs.