Why Pennsylvania Should Not Establish a Health Insurance Exchange
July 9, 2012: In his statement after the Supreme Court released its decision on the Affordable Care Act (ACA also known as ObamaCare), Governor Corbett said that his administration would work to “minimize” the harm to Pennsylvanians.
One of the major components of the ACA is the establishment of so called “Health Insurance Exchanges”. At his point, Pennsylvania has received a $33.8 million Level One grant from the federal Department of Health and Human Services to establish a state based exchange. The administration has in the past indicated that it was willing to establish a state based health insurance exchange based on the flawed assumption that the Commonwealth will be permitted to exercise control over implementation of the law.
First and foremost, let's dispel the myth that these exchanges would be similar to Expedia or Travelocity but for health insurance and would embrace free market principles. If that were the case, there are already options that have been set up in by private companies that allow consumers to get quotes on insurance policies from multiple providers with differing levels of coverage (ehealthinsurance.com and getinsured.com).
No, the main function of the states' so called exchanges is to administer billions of dollars in insurance subsidies and act as agents of the federal government. States that establish exchanges are willingly allowing themselves to be deceived.
The federal government controls the exchanges but, don’t take our word for it.
Look at what the law states:
An Exchange may not establish rules that conflict with or prevent the application of regulations promulgated by the Secretary [of Health and Human Services (HHS)]…. 42 U.S.C. § 18031(k)
Further, the Secretary and the General Accounting Office will have continuing oversight over exchanges. § 18033(a), (b)
The federal government controls the insurance plans and benefits:
…the Secretary shall define the essential health benefits…. 42 U.S.C. § 18022 (b)
The Secretary shall, by regulation, establish criteria for the certification of health plans as qualified health plans. § 18031 (c)(1)
In general An Exchange may not make available any health plan that is not a qualified health plan. § 18031 (d)(2)(B)(i)
Beyond the federal government having the final say over the exchanges and insurance plans, states that establish exchanges are also required to enforce the individual mandate and turn over information to federal authorities under a number of circumstances. 42 U.S.C. § 18031 (H) and (I)
Finally in exchange for all this “flexibility” and responsibility, Pennsylvania taxpayers will be responsible for covering the cost of operating the exchanges after 2014 via state tax dollars. It is worth noting that Pennsylvania is not required under the ACA to set up an exchange. At least nine governors have already refused to establish state based exchanges, with some of those refusing the federal grant money and others returning it after the Supreme Court decision.
Establishing a state based exchange will not minimize the harm to Pennsylvanians. As clearly illustrated, the federal government will be calling the shots and in the end taxpayers in Pennsylvania will have to pick up the tab. So, why are our leaders even entertaining the idea of establishing a state based exchange?
At this point, the best option to minimize harm to Pennsylvanians would be for Governor Corbett to unequivocally refuse to establish a state insurance exchange and send the money back to Washington.
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