Rip Van Winkle and State Health Insurance Exchanges

By on November 12, 2012

Observers are now watching to see which states will move ahead with the establishment of insurance exchanges where low to middle income Americans can come to purchase affordable health insurance. This of course is regardless of health status, pre-existing conditions and employment.

Many states were holding back to see the outcome of the national election, some no doubt hoping Romney would win and they would not have to do this. Governors Jindal of Louisiana and Perry of Texas rattled their sabers rather loudly in the Spring, indicating they had no intention of cooperating with such a federal usurpation of their power. They got left at the altar by both The Supreme Court this summer and the voters this fall. Now comes the winter of their discontent.

Governor Jindal

One state Missouri passed a referendum against the establishment of a state exchange. The Democratic governor there Jay Nixon kept his counsel on the matter, as the state has been trending increasingly to the right. The Federal government is moving to step in as the referendum outcome is essentially irrelevant. The governor now says he thinks the state should take this over in the future. Elections do have consequences.

These exchanges are a key feature of the PPACA as they will bring down the vast number of uninsured Americans, now topping 48 million by some estimates. It will also end the anxiety of working Americans with jobs, whose employer-provided coverage depends on the number of hours they work each week. Though unemployment has come down in the past four years, it does not mean that the jobs lost in 2008 have been replaced by comparable jobs with health care benefits.

Governor Nixon

Just the opposite, employers are chopping, chopping away at benefits,and turning full time jobs into multiple part time ones to avoid the financial burden of health insurance for their work force. As all Adult Americans  are required now to have health care insurance or pay a fine on their tax returns, guaranteeing access to affordable insurance is a priority.

Republican efforts to sell Obama-care as a government take-over of medicine in this country has probably run its course. I did however get a laugh yesterday when one member of the GOP said they were now enlisting the support of a conservative thinker to come up with an alternative to the PPACA. Too little too late. The opportunity to do this passed months, maybe years, ago. A Rip Van Winkle approach to 21st Century problems is a proven loser.

More on this to come.

Tom Godfrey

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