Nebraska, Ohio push forward on insurance exchanges despite opposition

Nebraska and Ohio are both considering measures that would set up health insurance exchanges in their states. Both measures are expected to face stiff opposition from Republican lawmakers that oppose federal health care reform. However, both Governor Heineman and Governor Kasich are expected to at least consider the measures to avoid, ‘federal takeover’ as implementation deadlines loom.

Under federal health care reform requirements states must create an online health insurance exchange marketplace that will allow individuals to compare insurance policies. States that do not create their own customized exchange will have one created and managed for them through the US Department of Health and Human Services.

States have until 2013 to create and implement their own exchange. Exchanges must be online by 2014 either in a customized or generic, federal format. These are some of the shortest deadlines for build-out of this type in recent history, but the administration has signaled that it wants states to move quickly to implement reform.

Several states opposed to the measure have opted out of creating an exchange claiming a variety of reasons from not wanting to use federal money, to overall constitutionality. The Supreme Court is expected to rule on the constitutionality of the law this year. However, states that have chosen to build an exchange have a limited window to create a plan and submit it for federal grant funds to support the creation of the exchange. Any unused funds will be reallocated once the deadline expires in 2013.

Nebraska and Ohio are the first of several states to take up measures in this new legislative cycle but they face a race to the finish line if they intend to use federal dollars to build their exchanges.

Nebraska is one of the states involved in the court challenge. Governor Dave Heineman has said he would like to see the law repealed, but is moving forward with designing a system, “to protect Nebraska from a federal takeover.” The Nebraska plan focuses its exchange on policies for individuals and small businesses.

Democrats in the Ohio legislature have proposed a similar plan, and while Governor Kasich is moving forward on examining the exchange he has said, democratic efforts in the state are premature. State lawmakers want to take advantage of federal funds to build the exchange but those applications require that a plan is in place. State legislators have also pointed out that they have no desire to allow federal takeover of the state exchange.

According to a piece in The Plain Dealer, Lt. Gov. Mary Taylor, who oversees the Department of Insurance, has said she will “do everything I can to protect Ohio’s citizens and job creators from this catastrophic law.”

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