As we discussed in a blog post Friday, states have until the end of this week to notify federal officials whether the state plans to move forward with a state-based health insurance exchange, a federally-facilitated exchange, or a state-federal partnership.  However, they will have an additional month to submit the blueprint, which details the state plan, if they decide to move forward with a state-based exchange (and until mid-February to submit a blueprint for a partnership exchange). This decision is surely not an easy one for Governor Scott Walker.

Many highly-invested and diverse health care stakeholders have urged the Governor to create a state-based exchange, including consumer advocates like WCCF, the National Federation of Independent Businesses, Wisconsin Manufacturers and Commerce, health insurers, the Wisconsin Medical Society, the Wisconsin Hospital Association, and the WI Democratic Congressional Delegation.  Scott Bauer’s AP story does a nice job of reporting on the strange bedfellows urging the Governor to move forward with a Wisconsin exchange.

However, members of the Tea Party, who are another significant base of support for the Governor, are urging Walker to reject implementation of the Affordable Care Act in Wisconsin, particularly by refusing to set-up Wisconsin health insurance exchanges.  If the Governor refuses to declare his intentions for a state-based or partnership exchange by Friday, the federal government will move forward with implementation of a federally-facilitated exchange in Wisconsin. 

At WCCF, we agree for many reasons with the broad spectrum of groups encouraging the Governor to move forward on creating Wisconsin’s own version of a health care exchange. While we are confident federal officials would be able to come up with an exchange that would function adequately and improve access to coverage, it makes much more sense for our state to develop its own exchange incorporating a more complete understanding of the unique needs and characteristics of Wisconsin’s health care market and health care consumers.

In particular, we believe that the unique nature of the health insurance marketplace in Wisconsin will be best served if state officials are able to certify health plans based on their self-determined regions of coverage. The strong community-based plans we have in our state need to be able to compete in our Wisconsin exchange for it to be successful.  If federal officials design and run the exchange, they might implement a plan that was a good design in Massachusetts or Rhode Island, but isn’t the best fit for our state’s local insurance markets.

We also believe that by establishing our own state-based exchange Wisconsin will be better able to coordinate coverage between BadgerCare and private exchange plans, since some parents with private coverage will continue to have children in BadgerCare.  A state-designed exchange plan is more likely to ensure that families have the option of choosing a plan in BadgerCare or the exchanges that has the same network of coverage, so we preserve our strong tradition of family-based coverage.

Governor Walker has a difficult decision to make by Friday. We agree with the Milwaukee Journal Sentinel editorial, and encourage him to put aside politics and make the best decision for families in Wisconsin. We look forward to working with him, or the federal government, in a transparent and accountable manner to come up with a plan that will allow Wisconsin to use the strategies made possible by the Affordable Care Act to remain a national leader in ensuring that everybody in the state has access to quality, affordable health care when they need it.

Sara Eskrich