Who Will Regulate Insurance Exchanges?
One of the key differences between the House and Senate versions of health reform — and perhaps one of the most difficult to hammer out — involves whether the proposed insurance exchanges will be regulated by the federal government or the states. (The Senate plan gives that authority to the states; the House keeps it with the federal government.) But, as a story in today’s New York Times illustrates, even if the House plan prevails, experts believe there will still be a substantive role the states must play to oversee compliance.
That’s why consumers and activists must pay particular attention to the actions of the Georgia General Assembly. Already, leading Republicans in the Legislature have indicated they will take action — something, they’re not sure what yet — that will attempt to thwart the impact of Washington’s plans on Georgia.
Think about how politics has played a role in how Georgia and other states have set up and administered their federally-subsidized Children’s Health Insurance programs (PeachCare in Georgia). Think about the Rube Goldberg-designed financing mechanisms for the state’s Medicaid program, two thirds of which comes from federal taxes. Historically, Georgia has never played well with federal rules, especially when it comes to health and human services, even when drawing down more federal financing than most other states. As the General Assembly begins the laborious budget-making process, think about how it might want to finance a state compliance office to regulate Georgia’s health insurance exchange. This is a key reform issue that advocates must watch closely.
– mike king
