Nov. 21--Speaking to a group of St. Louis business leaders last week, the new speaker of the Missouri House, Tim Jones, R-Eureka, suggested that lawmakers might eventually design a state health insurance exchange, rather than leaving the task to the federal government.
This is great news.
Feuding over health exchanges is a futile rear action in the political war against the Affordable Care Act. The Supreme Court has declared President Barack Obama's landmark health care reform law constitutional. The nation has voted Mr. Obama a second term. The ACA will remain the law of the land. It's time to move on.
Like Japanese soldiers hiding in caves on Okinawa, some Republicans are still fighting the war by refusing to implement the exchanges. In Missouri, Lt. Gov. Peter Kinder, a Republican, has suggested that's what should happen here.
At least for now, Mr. Jones doesn't seem to be listening to Mr. Kinder.
The irony here, is that like so many elements of the ACA, state-based health exchanges are very much in line with the traditional Republican "personal responsibility" mantra. They are meant to serve as a web-based clearinghouse for consumers, both individuals and businesses.
The ACA now requires insurance companies to allow their customers to compare the various options offered through employer-based plans. The health exchanges will allow those without employer-based plans to shop online for all of the options available to them.
This comparison shopping will encourage competition, with insurance companies knowing that their prices and benefits will be a click away, available to all.
The only question is whether Missouri designs its own exchange or if the federal government does it.
There is no doubt that most Missouri Republicans would take a state-based option. It's why the Missouri House voted 157-0 to design the state exchange in 2011. That was before Sen. Jane Cunningham, R-Chesterfield, started grandstanding on the issue.
So the Republicans wasted the last year on a disingenuous anti-Obamacare effort capped by the passage of Proposition E, which stopped Gov. Jay Nixon from implementing an exchange on his own.
Never mind that the governor had no intention of doing so, and probably couldn't have if he wanted to. Missouri voters had once again made their anti-Obamacare views made.
In doing so, they gave the federal government control over what would otherwise be a state process.
On Friday, Mr. Nixon notified Health and Human Services Secretary Kathleen Sebelius that it appeared unlikely that the state of Missouri would design its own health care exchange.
Back to the good news. Mr. Jones, and several members of his Republican caucus, are making tentative moves in the right direction.
"To refuse to create the exchange is to tell Missourians that they have to pay the costs of the law, but can't get any of the benefits," wrote state Rep. Jay Barnes, R-Jefferson City, on his blog. "That might make folks feel like they're newfound William Wallaces [think "Braveheart"] saving the Republic, but it will not change anything about federal policy -- and it will shortchange our own citizens."
It's time for partisanship to give way to reality. Elections have consequences, and the ACA is here to stay. Missouri lawmakers should make designing a state health exchange one of their first priorities in January.
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