Georgia, Ohio and Wisconsin joined more than a dozen other states on Friday in saying they would not establish health insuranceexchanges, while a handful of other states said they would take advantage of an extra month allowed by the Obama administration to make decisions.
The exchanges — online markets where consumers can shop for private insurance subsidized by the federal government — are a centerpiece of President Obama’s health care law.
Caroline F. Pearson, who tracks state developments at Avalere Health, a consulting company in Washington, said it appeared that about 18 states would choose to run their own exchanges, while 10 to 12 would seek partnerships with the federal government, and 18 to 20 would have federal exchanges.
¶Friday was to be the deadline for states to declare their intentions. But Ms. Sebelius said Thursday night that she was extending the deadline to Dec. 14. In any event, she must decide by Jan. 1 whether states are able to run their own exchanges.
The new chairman of the Republican Governors Association, Gov. Bobby Jindal of Louisiana, said he was sticking by his earlier decision not to create a state-based insurance exchange where the uninsured can buy subsidized coverage. The federal requirements are such, he said, that he thinks the state may as well opt for a federally run exchange.
“One of the reasons we have chosen not to operate the exchanges as a state is the reality is that they’re not really giving us the authority to make these decisions,” he said. “So it’s state responsibility without state authority, which doesn’t make a whole lot of sense in my book.”
¶Americans are supposed to be able to start shopping for insurance through exchanges in October 2013. By January 2014, most Americans will be required to have health insurance under the law.
Heather H. Howard, a lecturer at Princeton University who provides technical help to states as director of the State Health Reform Assistance Network, said the guidance provided by the Obama administration was sufficient for states to make decisions. States like California, Maryland and Washington have made great strides in developing exchanges, she said.
¶Ms. Howard said that governors might try to use the extra time to negotiate. “They’re feeling their oats and testing the limits of what leverage they have,” she said.
(Governor of my state, Georgia, will leave it to the federal government. Yahoo. I'm quite sure Georgia would not do as good a job of it as my old state, California, even under tight regulation.)
