Montana, North Dakota and Colorado are all moving forward on health care exchanges in their states but not with out a struggle. In Montana, Republicans in the state legislature oppose the implementation of the exchange through federal money leading the state insurance commissioner to apply for authority to move forward on her own. In North Dakota, a measure is set to go to the Governor for his signature that will establish the framework for a health exchange in line with federal health care reform requirements. In Colorado, a measure to set up the exchange has cleared the Senate but faces Republican opposition in the House.
Under the requirements of federal health care reform, states are required to submit a plan for establishing a health insurance exchange by January of 2013 and have the exchange fully up and running by 2014. The federal government has allocated funds to help states offset the cost of setting up these exchanges. Montana has received a $1 million grant from the federal government to set up its exchange but Republicans in the statehouse sent a measure to the Governor that would prohibit the state from using those funds or from setting up an exchange. The Governor vetoed the measure creating a deadlock in terms of what the state can do. Yesterday, Monica Lindeen, the MT Commissioner of Securities and Insurance, asked the legislature to grant her the authority to build the exchange on her own without a bill.
North Dakota is eligible for $27 million in grants from the federal government for exchange development, but not unless a plan is approved. The measure slated to go to the Governor does not put North Dakota in charge of running the exchange but it does establish a framework to create one. However, a competing bill in the legislature would prohibit the state from setting it up.
In Colorado, a measure that would establish a nine member board to develop the exchange has preliminary approval but faces Republican opposition in the House. Two amendments to the bill required Gov. John Hickenlooper to receive a federal waiver from health care reform before the exchanges would go into place, and ban the state from taking any federal money for the exchange failed along party lines. Amendments like these may come up again as the bill moves through the house.