Health care exchanges would be more responsive if state run

November 14, 2012 

There is a deadline looming for all 50 states to decide whether they will take on the responsibility of forming and operating health exchanges or deed that responsibility to the federal government. These health exchanges are part of the Affordable Health Care Act and have to be up and running by 2014.

Exactly what is a health exchange? According to the Kaiser Family Foundation, health exchanges are “new organizations that will be set up to create a more organized and competitive market for buying health insurance. They will offer a choice of different health plans, certifying plans that participate and providing information to help consumers better understand their options. Beginning in 2014, Exchanges will serve primarily individuals buying insurance on their own and small businesses with up to 100 employees.” Clear as mud, right?

The goal of health reform is to cover everyone with some sort of insurance. With everyone covered, the costs of health care should go down or its rate of increase slowed. States are falling into one of four categories, either studying exchange options, no activity, planning on a state exchange or planning on a federal exchange. Georgia, as were other states, was waiting for the outcome of the election before deciding in which direction to turn, hoping that Obamacare would be repealed if Republicans won the White House. They didn’t, so the scrum is on.

Gov. Nathan Deal has indicated that the state won’t form its own exchange and will allow the federal government to do the heavy lifting. Georgia is not alone, but those states can’t preach state’s rights and that local control will produce a better system and turn around and willfully hand over the reins for the health exchanges to the feds.

Having the feds step in does a disservice to those in the state who would use the exchanges. Instead of being able to buy locally and complain locally when something isn’t right, local could mean getting backed up in a federal bureaucracy. And while ceding control has its advantages, being in a position to steer such a program according to the needs of Georgians can’t be overstated. With the timeline for establishing health exchanges growing shorter, Gov. Deal should put his theory to the test that state government, being closer to the people, could do a better job. We may never know if that theory is accurate if the governor whiffs at the Friday deadline.

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