One of the laws that has been created through the health reform regulations requires all states to create their own health insurance exchange system by 2014. If a state chooses not to do this, then the federal government will step in and create their state’s exchange for them. Texas has recently decided against creating an exchange.
As always, there are two sides to this story. Governor Rick Perry is very strongly opposed to the health system reform law that requires each state to from a health insurance exchange system. He has stated that he would veto any legislation that would enable a state run exchange to be created.
A spokesperson for the governor, Lucy Nashed, said that Governor Rick Perry is hopeful that the Supreme Court will ultimately decide that the health care reform laws are unconstitutional. If Texas does not create an exchange, the Department of Health and Human Services will create and operate a federally run health insurance exchange in that state.
Representative John Zerwas, MD, was the person who sponsored the bill that, if passed, would authorize the creation of the Texas health insurance exchange. That bill was supported by the Texas Medical Association President Bruce Malone, MD. It is worth noting, however, that Bruce Malone was not thrilled with the subsidies that the health exchange would offer to people who could not afford to purchase health insurance. He called those subsidies “middle-class welfare entitlement”.
Texas might create a “health care collaborative”, which would be a type of accountable care organization. It is expected that doctors are going to be very skeptical about these collaboratives, especially when there are a lot of details that are still unknown. The collaborative would not be considered a form of health insurance exchange by the federal government.
Just to make things clear, so far Texas and Minnesota decided not to create a health insurance exchange for their state. California was one of the first states, if not the first, to begin working on their state’s exchange. Vermont and Colorado have approved bills that would allow their state to start making health insurance exchanges. New York, last I heard, was still going over the logistics that the creation of exchanges would require.
In February of 2011, seven states received grants that would help them be able to pay for the cost of creating an exchange. Those states were: Oklahoma, Oregon, Wisconsin, Massachusetts, Kansas, New York, and Maryland.
Image by Calsidyrose on Flickr