WASHINGTON BUREAU — Twenty-one Republican governors are asking the Obama administration to change the rules for setting up and running the new Affordable Care Act health insurance exchange programs.
The governors are warning that, if the U.S. Department of Health and Human Services (HHS) fails to make the changes, the governors will give HHS full responsibility for setting up and running the exchanges in their states.
"We believe the system proposed by the PPACA is seriously flawed, favors 
dependency over personal responsibility, and will ultimately destroy the private insurance market," the governors write in the letter. "Because of this, we do not wish to be the federal government's agents in this policy in its present form."
The Affordable Care Act, the federal legislative package that includes the Patient Protection and Affordable Care Act (PPACA), encourages states to set up exchanges for distributing subsidized individual and small group health coverage by 2014.
In states that do not set up health insurance exchange programs or participate in multi-state exchange programs, HHS is supposed to provide exchange services for the residents of those states.
The governors are asking HHS to:
- Give the states more authority to choose benefits that meet the needs of their citizens.
- Waive provisions that, they say, discriminate against health insurance arrangements that include health savings accounts or health reimbursement arrangements.
- Provide a comprehensive plan for verifying incomes and subsidy amounts for exchange participants "that is not an unfunded mandate but rather fully funded by the federal government and is certified as workable by an independent auditor."
- Provide "blanket discretion" to let governors have non-disabled Medicaid beneficiaries get their insurance coverage through the exchanges.
- Commission an independent assessment of how many people employers will "offload" into the exchanges. "The study must be conducted by a neutral third-party research organization agreed to by the states represented in this letter," the governors say.
HHS officials say in a statement that HHS is
providing money to help states implement the PPACA exchange provisions and is prepared to be flexible about the exchange program rules.
"The Affordable Care Act helps control costs, while giving states the flexibility to make the law work for them and the opportunity to take the lead role in delivering the benefits of reform to their residents," says Jessica Santillo, a representative for HHS Secretary Kathleen Sebelius.
Since the act was enacted, "HHS has made resources available to the states to both plan and establish exchanges and made clear we will consider different models that fit states' needs," Santillo says. "We look forward to continuing to build a constructive partnership with governors and state leaders."
© Arc, All Rights Reserved. Request academic re-use from www.copyright.com. All other uses, submit a request to TMSalesOperations@arc-network.com. For more information visit Asset & Logo Licensing.