State health insurance exchanges

Will the GOP cut off its nose twice to spite its face?

Today, we received a reminder from our friends at Families USA that the road to health reform has plenty of potholes ahead.

A statement from Families USA condemns House Republican plans to vote on a bill to block the delivery of ACA grants that are intended to help states establish health insurance exchanges – the new state-based marketplaces created as part of the Affordable Care Act.

As Ron Pollack, Executive Director of Families USA aptly points out, the attempt to de-fund the exchanges flies in the face of the opponents’ “long-stated principles.”

Pollack’s right. This vote is yet another act of political theater from legislators who promise to give states more control, but then pass legislation that puts Congress in the driver’s seat. It’s a classic example of cutting off  your nose to spite your face.

Unhindered, states would have a great deal of flexibility to design their own customized health insurance marketplaces – as long as they ensure that health carriers meet standards that improve access and plan quality for consumers. This legislation would hinder the states ability to even try to create their own consumer-friendly exchanges.

These congressional opponents have co-conspirators in the state legislatures, as several of those bodies have either refused the grants or failed to pass legislation authorizing the establishment of state exchanges. But, as this piece today on Politico points out, the executive branch in some states like Arkansas are trying to do end runs on the Republican legislators who are working to block health reform provisions.

The article notes that – interestingly enough – success in blocking state-fashioned exchanges won’t give opposition a certain victory.

If states do not have the framework in place for an exchange by 2013, the Department of Health and Human Services will come into the state and do the job itself.

This action is a disservice to voters, a waste of time for state legislatures already working on their exchanges, and ultimately – we think – self-defeating. Seems to us that the reform opposition is working overtime to find an extra nose on its face to cut off.

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