Health Care Exchange? NOT SO FAST!

Weekly Opinion Editorial

HEALTH CARE EXCHANGE?- NOT SO FAST!

by Steve Fair     

     A health care exchange is a set of state-regulated and standardized health care plans in the United States, from which individuals may purchase health insurance eligible for federal subsidies. Under federal law, all exchanges must be fully certified and operational by January 1, 2014.  The exchange – envisioned as an easy-to-use, online insurance marketplace for consumers who need an individual health plan – is the heart of ObamaCare and the piece that will impact consumers most directly.
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     In theory, using an exchange could be much simpler than the current way that people buy insurance. Right now, consumers have to dig through technical jargon and complicated premiums, copays, deductibles and hidden exclusions to compare one plan with another.
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     As envisioned by ObamaCare, an online exchange would have simple, side-by-side comparisons of health plans. Depending on how the exchange is set up, it could also prescreen the health plans available to make sure they are comprehensive and as affordable as possible. The exchanges could pull together large groups of people – such as combining both individuals and employees of small businesses – to make a bigger pool and keep prices down or not since all of this is theoretical and untested.
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     Currently your best option for reducing the cost of your health insurance is to buy a policy with a high deductible, which leaves you to pay for routine checkups and minor injuries... but covers your needs in catastrophic circumstances.  If you have a bad car accident or expensive treatment for cancer, your insurance would kick in. But the health-insurance exchange is intended to eliminate precisely this kind of low-cost catastrophic coverage. Its purpose is to force health-insurance companies to offer ‘comprehensive coverage’ that pays for all of your routine bills - which in turn comes at a higher price. So under the guise of making health insurance more affordable, ObamaCare will restrict your menu of choices to include only the most expensive options.

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     The liberal New York Times says it’s time to get those state exchanges up and going.  In an editorial last week, they wrote, “Many states are well on the way toward setting up exchanges, a complicated process in which governance procedures must be established, standards must be set for the plans that will compete and new information technologies put in place. The big uncertainty is how many Republican-led states will refuse to set up exchanges either because they adamantly oppose all aspects of the reform law or because they are reluctant to spend any time, effort or money to set up a mechanism that they hope Republicans will repeal after the November elections. That sounds like wishful thinking. States would be foolish to rely on it with deadlines fast approaching.”
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    Not everyone agrees, including Oklahoma U.S. Senator Tom Coburn.  Dr. Coburn, eleven other Republican Senators and sixty members of the U.S. House sent a letter to every Governor across the country urging them to not bend to federal pressure to set up the complicated health care exchanges.  In the letter, they wrote, “These expensive, complex, and intrusive exchanges impose a threat to the financial stability of our already-fragile state economies with no certainty of a limit to total enrollment numbers. Resisting the implementation of exchanges is good for hiring and investment. The law’s employer mandate assesses penalties – up to $3,000 per employee - only to businesses who don’t satisfy federally-approved health insurance standards and whose employees receive “premium assistance” through the exchanges.  The clear language of the statute only permits federal premium assistance to citizens of states who create a state-based exchange.”
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    It’s unclear where Oklahoma Governor Mary Fallin and the legislative leadership is on the issue of the health care exchange.  In 2011, Governor Fallin and the State House and Senate agreed to accept a $54 million federal grant to set up a health care exchange. Conservatives became enraged and the blowback produced an about-face and a return of the grant. Last fall, a legislative committee studied possible state responses to the law if ObamaCare was found to be constitutional, but no action was taken during the legislative session. 

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      The federal lawmakers concluded their letter to the Governors by saying, “Implementation of this law is not inevitable and without the unconstitutional individual mandate it is improbable.  Join us in resisting a centralized government approach to health care reform and instead focus on solutions that make health care more affordable and accessible for every American. Let’s work to create a health care system of, for, and by the people, not government or special interests.”

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     The best way to handle the health care exchange is at the ballot box in November.  Americans should take back their government and give Republicans control of both houses of Congress and the White House.