Now that the U.S. Supreme Court has upheld the Affordable Care Act, Missouri has until November 16 to submit a blueprint for its healthcare exchange program. Otherwise, the federal government will do it.
A healthcare exchange creates a market for people to compare insurance policies.
“Healthcare exchanges are intended to create a more organized and competitive market for health insurance by offering a choice of plans, establishing common rules regarding the offering and pricing of insurance, and providing information to help consumers better understand the options available to them,” according to the Henry J. Kaiser Family Foundation.
Incoming Speaker of the Missouri House of Representatives Timothy Jones (R-Eureka) said his party doesn’t plan to set up an exchange at this time.
“We don’t see any reason to spend any resources until after the November election,” he said.
Jones said he believes Republican presidential candidate Mitt Romney will repeal the law if he becomes president, so setting up an exchange would be a waste of time.
According to Chris Dunn, a legislative staff member for State Sen. Rob Schaaf (R-Buchanan and Platte County), Missouri nearly started building a healthcare exchange based on an executive order by Gov. Jay Nixon. In September 2010, the Missouri Department of Insurance received a federal exchange planning grant for $1 million. At the time The Missouri Health Insurance Pool, a public-private agency was originally going to expand its high-risk pool into the exchange. On August 12, 2011 the MHIP received a $21 million federal grant to build the exchange.
According to Dunn, a Senate Interim Committee then stopped the pool during an annual MHIP retreat just as the exchange was getting started.
“The state-based exchange should be made in the legislative body,” Dunn said.
Dunn also criticized the MHIP. He said many board members were insurance executives.
As a result, Schaaf proposed Senate Bill 464, which will be on the ballot in November and gives the legislature power to create a state exchange. The law specifically prohibits the establishment of a state-based exchange by an executive order from the governor.
What Happens Next
Dunn said Sen.Schaaf is not in favor of any healthcare exchange. Incoming Speaker Jones said it would be possible to set up a joint interim committee to look into exchanges if the Affordable Care Act is not repealed following the November elections.
Jones, a lawyer, also said there was another possibility. According to Jones, both Gov. Sam Brownback (R-Kansas) and Gov. Bobby Jindal (R-Louisiana) have threatened to ignore the Supreme Court ruling.
Jones believes he has a mandate from Missourians to ignore the healthcare law. In August, 2010, Missourians voted overwhelmingly to repeal the individual mandate in the Affordable Care Act. The referendum, known as Proposition C, passed with 70 percent of the vote.