With Deadline Extended, about 10 Governors are Still Considering the Options
As you have no doubt heard, Governor Walker sent a letter to Secretary Sebelius on Friday declaring that Wisconsin will not develop and operate a health insurance exchange, which means that the federal government will take on that responsibility in our state. As WCCF executive director Ken Taylor commented, Walker’s decision is disappointing because state officials would probably be able to do a better job of tailoring the exchange to make it a good fit for Wisconsin’s insurance market.
Next week I’ll respond to the Governor’s rationale for his decision. However, you can now find a broad range of responses to that decision on the Wheeler Report website.
Friday was supposed to be the deadline for states to inform federal officials whether they would design and operate the exchange in their state; but with many states saying they needed more time, Secretary Sebelius decided late Thursday afternoon to give governors another month to make their decisions. Nevertheless, Walker chose to make his announcement Friday, as did a number of other governors.As of late Friday, governors in 18 states had announced that they would not implement a state exchange. Although most of the “red” states have decided to defer to the federal government, not all of the states that voted for Romney have rejected state exchanges. As this map shows, a handful of states with Republican governors or legislatures have started making plans for state-run exchanges, and other conservative states are still considering it.
One of the purple states planning an exchange is Kentucky. Milwaukee Public Radio (WUWM) aired a good interview with a Kentucky official about the exchange development efforts there and lessons learned. Some of the other states developing their own exchanges are Mississippi, Nevada, and West Virginia. (Iowa is also shown on the map as committed to a state exchange, but I would question that designation, because Governor Branstad’s letter indicates that he is still undecided.)
According to a New York Times article, a number of Republican governors “said they would use the extra time [provided by Secretary Sebelius] to seek more answers from Washington and feedback from constituents.” In addition to Branstad, those GOP governors are Jan Brewer of Arizona, C. L. Otter of Idaho, Chris Christie of New Jersey, Tom Corbett of Pennsylvania and Bill Haslam of Tennessee.
Even if a few of those governors decide to set up state exchanges, the large number of states that are deferring that job to the federal government is likely to create a tremendous challenge for the Department of Health and Human Services. How well HHS and the states that are building their own exchanges accomplish the task will have important consequences for consumers and for the effectiveness of the interface between exchanges and Medicaid.
A very interesting Huffington Post article examines some of the practical consequences and political implications.
Jon Peacock
