LANSING – Governor Rick Snyder on Friday took action on complying with the federal Patient Protection and Affordable Care Act by declaring that he had filed a grant application to the U.S. Department of Health and Human Services to collaborate on a state-federal partnership exchange, but left just enough bait for the House to possibly act on a strictly state-run health care exchange as well.
“We must be realistic about how feasible implementing this could be under the current federal timeframes. At this point we’re moving toward a state partnership exchange,” Snyder said in a statement. “However, we will continue to work with our legislative partners and seek more details and clarity from the federal government to make a final determination on Michigan’s path forward – whether that’s a state partnership exchange or state-based exchange.”
If additional federal deadlines are extended or the state Legislature takes action to authorize a state-based exchange, the governor may decide instead to implement the MI Health Marketplace laid out in SB 693.
The Senate passed the bill more than a year ago, but the House has been reluctant to take action on the bill – first in hopes the ACA would be decided unconstitutional and after arguing that another president such as former Massachusetts Governor Mitt Romney would repeal it.
House Speaker Jase Bolger (R-Marshall) issued a statement following the announcement by Snyder saying that, while he still disagrees with the Affordable Care Act, he would much prefer a state-planned, state-run, state-operated exchange over giving the OK for the federal government to make decisions for Michigan residents.
“The House will continue to work with the Governor to ensure that Michigan residents’ needs are met and their interests are heard,” he said. “Most central to that partnership is determining Michigan’s best choice for this exchange that is coming; whether federally-imposed, a state/federal partnership, or a state run exchange.”
Rep. Gail Haines (R-Lake Angelus), chair of the House Health Policy Committee, has also said she would like to explore some of these avenues before making a finite decision (See Gongwer Michigan Report, November 13, 2012). Though some operational deadlines have changed, the next big deadline for the state is December 14, when it must declare if it wishes to operate its own exchange.
Some House Democrats expressed their frustration over the reluctance by House Republicans and urged action as soon as possible.
“After stalling for months and using the presidential election as an excuse, Rep. (Gail) Haines and the House leadership now realize that we need to move on creating a Michigan Health Care Exchange, but they still aren’t moving fast enough,” House Minority Floor Leader Kate Segal (D-Battle Creek) said in a statement.
Rep. Alberta Tinsley-Talabi (D-Detroit) said waiting any longer would hurt Michigan residents.
“The Affordable Care Act is the law of the land, and it goes without question that Michigan officials are in the best position to create a health exchange for our citizens,” she said in a statement. “If we wait any longer for hearings and discussion then we are short-changing ourselves and Michigan residents. We need to start now and have a serious discussion on this very important issue.”
But both the House and the Department of Licensing and Regulatory Affairs say there are still a number of questions left to answer in terms of what the state would be permitted to do by having its own exchange versus having an alliance with the federal government. That is, aside from “ownership” issues, how much of a role would the state actually have under each option?
“With a state-federal partnership, we’ve always envisioned a number of functions the exchange would do itself,” said Shelly Edgerton, deputy director of the department, which is expected to oversee the implementation of the exchange. “With a state partnership there are essentially two functions the state is allowed to do in conjunction with the federal government: plan management and customer assistance.”
Plan management refers to the management of insurance carriers that would offer plans on the exchange, a function that the Office of Financial and Insurance Regulation already does for licensed carriers in the state, she said. But the department is less clear on what exactly is involved with the “customer assistance” portion as it relates navigators, agents and brokers. The federal government would likely run the hotline and website.
But Edgerton said the department would look at all avenues it can to assist Michigan citizens in the transition process, especially in terms of understanding the way the system works and how it can be used.
“Simply put, while many questions remain unanswered from the federal government, I believe it is better for the state to seize control and answer those questions for ourselves and to do so before Dec. 14,” Bolger said. “The state can determine whether we have more than a hundred insurance choices and robust competition to benefit Michigan consumers like Utah rather than risk allowing the federal government to determine only a few options are offered as is done in some states.”
He added: “Our worst fears of the federal government’s path is a single payer system or government takeover of our patients’ health care; while this does not exist today, a move to this would be made much easier through the federal government running Michigan’s exchange rather than having Michigan in control and ensuring consumer choices for our families.”
This story was provided by Gongwer News Service. To subscribe, click on Gongwer.Com
