The Obama administration, after governors asked for more time to make a decision, announced on Thursday that states will have an extra month to say whether they plan to operate their own health insurance exchanges. The announcement from U.S. Health and Human Services Secretary Kathleen Sebelius was in the form of a letter to the governor of each state.
Sebelius said in the letter, “While receiving a letter of intent now will help us assist states in finalizing their application, a state may submit both a letter of intent and an application to operate its own exchange by Dec. 14.”
The Omaha metro area will have two different approaches for businesses and individuals living in the area. Nebraska Governor Dave Heineman, just prior to the previously established deadline of November 16th, announced Thursday that Nebraska will not operate its own health insurance exchange because a state-run program is too expensive.
Iowa had announced its intention to form a state operated exchange in June of this year. The basis of the Iowa plan was made available through a slide presentation entitled “ Health Benefit Exchange 101”.
A web site for the Iowa exchange has been available since June. The site is incomplete at this time and states “This information exchange is designed to help Iowans research the options available to them as they search for health insurance coverage, whether in the private policy market or through some public program for themselves or for children in their family. This exchange was mandated by the passage of an Iowa law in 2010 strictly for this informational purpose. No purchase of insurance will occur through this information exchange.”
Nebraska opted for a federally run program, even though a heavy advertising campaign in Nebraska by the Nebraska Health Care Alliance asked for a state run program. The Alliance is made up of hospitals, insurance companies, and medical associations. In his announcement Heineman said creating a state exchange would have cost Nebraska taxpayers $470 million more than a federally run exchange.
Bruce Rieker, vice president of the Nebraska Hospital Association, said his group would not try to overturn the governor’s decision.
However, that does not mean that Nebraska has settled the differences over the Affordable Care Act. Omaha Sen. Jeremy Nordquist indicated that he will introduce legislation that would extend Medicaid coverage. Both Gov. Heineman and U.S. Sen. Mike Johanns (R) have opposed the expansion.
The Affordable Care Act required expansion of Medicaid. However, the U.S. Supreme Court ruled in June that the federal government cannot penalize states that refuse to participate.