Rod Boshart, CR Gazette –
DES MOINES – Iowa could meet the federal deadline for establishing a state-run health insurance exchange if Gov. Terry Branstad would call lawmakers into special session and hammer out a bipartisan agreement before next month’s application deadline, Sen. Jack Hatch said Monday.
However, the Des Moines Democrat said it does not appear like that’s going to happen because Branstad, like other Republican governors, remains in denial that the Affordable Health Care Act is moving forward and likely will force the state to operate under a federally facilitated program in 2014 with the best case for Iowa officials to supplant it with a state-run exchange likely being a year later if the split-control Legislature and GOP governor can find common ground.
Branstad notified federal officials Friday that Iowa policymakers intend to create a state-based health insurance exchange under the Patient Protection and Affordable Care Act but need many questions answered before they will be in a position to proceed. The governor told reporters Monday “we’re looking at all options” but added that he is frustrated by the process, does not believe federal officials are prepared to move ahead with the exchanges and questions whether they could afford to finance expansion in Medicaid and other commitments tied to the health care expansion.
However, Hatch said Branstad was misrepresenting the unfolding situation and has not expressed federal funding concerns for transportation, disaster aid, farm payments and education commitments.
“The state-run option is gone. He acknowledged it last Friday. He said he was not going to submit a state-based exchange. He’s trying to have it both ways. He’s still living in this fantasy that he can have it both ways,” Hatch said.
“His wish for a state-based exchange is only possible in 2015 at the earliest,” he added. “If he wanted to have a state-based exchange by 2014, he has three weeks to do that. He could call a special session of the Legislature and in one day we could give him the authority to do a state-based exchange with qualifications. That bill has been out there. We could negotiate that now if he wanted to but he doesn’t. He wants to go along with the ultra conservative governors to throw up road blocks for consumers in Iowa to have exchanges available to them to buy private health insurance.”
Hatch noted that the Obama administration awarded the state of Iowa more than $7.7 million to begin setting up a health insurance exchange, a central element of the controversial federal health care reform law. With that money, he said, the state should have been able to get all questions answered and proceed with implementing exchanges that have been established in 17 states and the District of Columbia.
Last week, Branstad sent a letter to Kathleen Sebelius, head of the U.S. Department of Health & Human Services, detailing 50 questions he wants answered to make an informed decision and criticizing the “intrusive” federal mandate.
“I cannot provide you with a set of timelines or complete details about the exchange until our state receives clear, binding rules from your department,” Branstad said in his letter.
“Forcing an exchange decision on states based on an arbitrary timetable, would be like forcing a consumer to buy a car without knowing the vehicle’s price tag or fuel economy,” he added. “If forced to make a decision with incomplete information, then I have no choice but to default on some level to a federal exchange. That is not my preferred path forward.”
The federal legislation allows states to implement their own exchanges, enter into a partnership with the federal government or allow federal officials to spell out operations of an exchange for them.
Under the health care exchange, individuals and small businesses would use the new framework to shop for health insurance among competing private plans and receive subsidies. The law – intended to make health coverage available to most of the uninsured – calls for legislation to be enacted before Jan. 1 or the government will step in to establish a federally operated exchange.