States’ Choices Set Up National Health Experiment
|By RICARDO ALONSO-ZALDIVAR, Associated Press|
The nation is about evenly split between states that decided by Friday's deadline they want a say in running new insurance markets and states that are defaulting to federal control because they don't want to participate in "Obamacare." That choice was left to state governments under the law: Establish the market or
With some exceptions, states led by Democrats opted to set up their own markets, called exchanges, and Republican-led states declined.
Only months from the official launch, exchanges are supposed to make the mind-boggling task of buying health insurance more like shopping on
<p> "It's an experiment between the feds and the states, and among the states themselves," said
Whether or not the bugs get worked out, consumers will be able to start signing up
Barring last-minute switches that may not be revealed until next week, 23 states plus
Twenty-six states are defaulting to the feds. But in several of those, Republican governors are trying to carve out some kind of role by negotiating with federal Health and Human Services Secretary
"It's healthy for the states to have various choices," said
States setting up their own exchanges are already taking different paths. Some will operate their markets much like major employers run their health plans, as "active purchasers" offering a limited choice of insurance carriers to drive better bargains. Others will open their markets to all insurers that meet basic standards, and let consumers decide.
Obama's Affordable Care Act remains politically divisive, but state insurance exchanges enjoy broad public support. Setting up a new market was central to former Republican presidential candidate
A recent AP poll found that Americans prefer to have states run the new markets by 63 percent to 32 percent. Among conservatives the margin was nearly 4-1 in favor of state control. But with some exceptions, including
"There is a sense of irony that it's the more conservative states" yielding to federal control, said
They're not budging in
In some ways, the federal government has a head start on the states. It already operates the Medicare Plan Finder for health insurance and prescription plans that serve seniors, and the Federal Employees Health Benefits Program. Both have many of the features of the new insurance markets.
Administration officials are keeping mum about what the new federal exchange will look like, except that it will open on time and people in all 50 states will have the coverage they're entitled to by law.
He thinks consumers should be able to get
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