State governments seek to circumvent legislatures, set up health care exchanges

However, like state Rep. John Zerwas, R-Katy, an Affordable Care Act foe who introduced an all but dead health care exchange bill here, these officials would rather initiate their own system than have one imposed on them by the Department of Health and Human Services, according to a story today on Politico.

Health care exchanges are designed to offer a government-managed market for federally insured clients to choose their plans. The Affordable Care Act mandates that all states establish exchanges by 2014 or have it done for them.

Many conservatives like the health exchange idea, in theory, because it represents the kind of free market reforms of government-funded health care they support. Many of those same conservatives do not want to appear to be cooperating with the Affordable Care Act while at the same time supporting a lawsuit making its way to the Supreme Court, contending that the health care bill is unconstitutional.

Govs. Nathan Deal of Georgia and Susana Martinez of New Mexico, both Republicans, have already vetoed health care exchanges in their states. Legislatures controlled by Republicans, such as Mississippi, have bottled up exchange bills in committee.

Instead, the Mississippi Insurance Department wants to set up an exchange in the state high-risk health insurance pool, believing it possesses authority outside of the Legislature.

“Our initial goal was to get some specific legislation to address this issue. That failed, and so now we’re looking at another option,” Aaron Sisk, staff attorney for the department, told Politico. “So now we’re looking at other options in the state, and this is certainly one of them. I think the exchange run by the high-risk pool would function exactly the same as we envisioned the exchange functioning as in draft legislation.”

Having vetoed an exchange bill under heavy citizen pressure, Deal’s staff told Politico he is probably going to use his power of executive order to set up an exchange anyway.

That executive order maneuver to skirt the legislative process ought to be just the ticket to quell citizen opposition.

Photo of pills by flickr user e-MagineArt.com, used via a Creative Commons license.