November 19, 2012: why ObamaCare is still no sure thing
At its core, ObamaCare is a massive entitlement expansion. Between vastly increased Medicaid eligibility and new premium subsidies, it is expected to bring 30 million more people onto the federal government's entitlement rolls. The law anticipates that the states will take on the burden of implementing the expansions, but states can opt out of both (exchanges and expansion of Medicaid).November 19, 2012: it looks like North Dakota got it right (again) on this one, deferring to the Federal government on health exchanges. Look at the California experience.
"We are in our countdown period," said Peter Lee, executive director of Covered California, the state's new health insurance marketplace that opens in October 2013.
Under the federal law, the state-run exchange aims to fundamentally reshape the health insurance market by negotiating with insurers for the best rates and assisting consumers in choosing a plan. The exchange must also help millions of Californians figure out whether they qualify for an expansion of Medicaid, the government insurance for the poor, or federally subsidized private coverage.
Federal officials have a lot riding on the California effort. How the state's insurance exchange fares will be an important test of [ObamaCare] at a time when many Republican-led states are resisting implementation. California leaders also hope they can harness the purchasing power of the exchange to improve patient care and make healthcare more affordable.
All of that, however, depends on getting enough people — healthy and unhealthy, uninsured and insured — to enroll. If that doesn't happen, the state could lose billions in federal dollars and insurance premiums could soar. The task is daunting, given the size and diversity of California's population, said Paul Fearer, an exchange board member.Where is Cesar Chavez when we need him? He could max out the enrollment lists.
November 18, 2012: for the informationally-challenged: link to ObamaCare.
Original PostLink here to LA Times.
State exchanges: California, Colorado, Connecticut, Hawaii, Iowa, Kentucky, Maryland, Massachusetts, Minnesota, Mississippi, Nevada, New Mexico, New York, Oregon, Rhode Island, Vermont and Washington (as of November, 2012)
No-state exchanges (defer to the federal exchange): Alabama, Alaska, Georgia, Indiana, Kansas, Louisiana, Maine, Missouri, Nebraska, North Dakota, Ohio, South Carolina, South Dakota, Texas, Virginia, Wisconsin and Wyoming (as of November, 2012)
Partnership exchanges with the federal government: Illinois (as of November, 2012) -- hardly surprising
Undecided about exchanges, state vs federal government: Arizona, Arkansas, Florida, Idaho, Michigan, New Hampshire, New Jersey, Oklahoma, Pennsylvania, Tennessee, Utah and West Virginia (as of November, 2012)