States refusing to develop health insurance exchanges are ignoring their citizens.
In what seems to be a perverse reversal of logic for many Republican governors who vehemently advocate for state’s rights, a majority of them are abdicating the control and money for Affordable Care Act mandated Health Insurance Exchanges to the federal government. It is also the states choosing not to be involved in their citizen’s insurance decisions that have populations with health challenges that on average are worse than the rest of the nation.
Most of the governors opposed to helping create their own state health insurance exchange are arguing that it will be too expensive. Ultimately, their lack of participation will increase insurance costs for their citizens as the ACA individual mandate is now the law of the land. [Click on thumbnail of table to enlarge to full size.]
Florida Governor Inflates Cost Of Medicaid Expansion By 2,500% To Avoid Implementing Obamacare
States challenging the ACA have some the highest uninsured populations.
Wisconsin: State won’t set up health insurance exchange, Walker tells feds
Louisiana: Jindal’s refusal of insurance exchange draws criticism
Texas: Gov. Rick Perry officially refuses to set up Texas health insurance exchange under Obamacare
Gov. Perry wrote,
It would not be fiscally responsible to put hard-working Texans on the financial hook for an unknown amount of money to operate a system under rules that have not even been written.
Does he understand that setting up his own Texas health insurance exchange allows him to write some of those rules?
Spite is not a plan
Some of the highest rates of people with no health insurance are in states with Republican
Health insurance can reduce the death of children.
governors that continue to challenge the constitutionality of the Affordable Care Act upheld by the Supreme Court in 2012. Spite is not a way to govern just because a governor doesn’t like the law.
Put children first
One measurement of how well a state is protecting the health of its children is to look the Infant, Child and Teenager death rates. When a state gets involved in setting up the health insurance exchange, they have more control to address issues of concern. This would seem like a prime time for Wyoming and South Dakota which have almost twice the national average of teen deaths to look for solutions to reduce the statistic.
Governors should act to protect their citizens
Cancer, firearm and suicide related deaths are also higher than the national averages among states steadfastly opposed to implementing the ACA. How can a
governor of a state with obvious health related issues among his or her citizens refuse to take
Reducing the death rate of citizens should come before politics.
action? It almost seems as if they are ignoring their responsibility to help their own people when all the tools are being offered to them.
Subsidies only through exchanges
Here is the key to the state health insurance exchanges; only health insurance plans purchased through the exchanges will qualify for the federal subsidy. If a family or individual purchases health insurance outside of the exchange, even if their income qualifies them for a subsidy, they won’t receive it. Outreach and education of this important fact will not happen unless that state gets involved. Not getting involved with setting up an exchange exposes purchasers to potentially higher premiums for lack of education.
A second important aspect of health insurance under the ACA is that all the plans offered will have to include specific essential health benefits. Consequently, health insurance premiums will be relatively similar throughout the nation. However, those areas that have populations with more health problems will see higher premiums because of the way actuaries must set the benefit levels.
Design an exchange for the citizens
For example, the Silver Plan in the health exchange must cover 70% of the all the enrolled
States can tailor health insurance exchanges to meet the needs of citizens.
member’s healthcare expenses based on the actuarial estimates of the member pool. If the enrolled members of that state have higher costs because illnesses, the premiums will necessarily rise to keep pace with expenses. Governors that actively oppose the ACA and involvement with setting up a state exchange are further penalizing their citizens with potentially higher costs and lower participation in health insurance plans that can reduce illnesses in their communities.
Governors who ignore involvement in the health insurance exchanges are only setting up their citizens for higher health insurance premiums. They will have missed the opportunity to help create an exchange that best works for their state and become eligible for federal money to help educate their citizens about the coming mandate.
They are sure to complain
We will undoubtedly hear in 2014 from governors and their citizens from states that shunned participation in the health insurance exchanges that the federally administered system programs don’t work and are too expensive. They will decry the federal take over of the health insurance system when all they had to do was to become proactive and create their own exchange tailored to fit the needs of their particular state.
All statistics were gleaned from The Henry J. Kaiser Family Foundation statehealthfacts.org