Obamacare

Building ObamaCare's Insurance Exchanges Won't Be Easy

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In my article on the new, state-based health insurance exchanges last week, I noted some of the difficulties states are likely to have with implementation. Today, Politico points to another potential trouble spot:

The biggest obstacle for Medicaid programs, according to a recent study by the nonpartisan Kaiser Family Foundation's Commission on Medicaid and the Uninsured, is setting up the new eligibility processes for the state insurance exchanges. People will be able to go to an exchange to determine in one swoop if they're eligible for Medicaid, for the law's tax subsidies or for buying insurance through the exchange.

The recent fight between insurers and California's state government over the passage of its exchange regulations made it clear that the creation of these new insurance marketplaces will entail a fair amount of political controversy in addition to implementation headaches. It will be most interesting to watch the politics play out in conservative states. Those states will be tasked with building and running exchange sunder fairly strict HHS scrutiny, a prospect that won't appeal to a lot of conservative governors or their voters. But the most obvious alternative they have is to step aside and allow the federal government to run the exchange directly, which may be even less appealing.

Much more on how ObamaCare will play out at the state level here.

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  1. It don’t come easy
    You know it don’t come easy
    It don’t come easy
    You know it don’t come easy

    Got to pay your dues if you wanna sing the blues
    And you know it don’t come easy
    You don’t have to shout or leap about
    You can even play them easy

    Open up your heart, let’s come together
    Use a little love and we will make it work out better

    I don’t ask for much, I only want your trust
    And you know it don’t come easy
    And this love of mine keeps growing all the time
    And you know it don’t come easy

    Peace, remember peace is how we make it
    Here within your reach if you’re big enough to take it

    Got to pay your dues if you wanna sing the blues
    And you know it don’t come easy
    You don’t have to shout or leap about
    You can even play them easy

    Peace, remember peace is how we make it
    Here within your reach if you’re big enough to take it

    I don’t ask for much, I only want your trust
    And you know it don’t come easy
    And this love of mine keeps growing all the time
    And you know it don’t come easy

    1. “It ain’t easy to get to Heaven when you’re going down”

  2. People will be able to go to an exchange to determine in one swoop if they’re eligible for Medicaid, for the law’s tax subsidies or for buying insurance through the exchange.

    Get ready to have your fingernails pulled…

  3. Well we passed the bill!! Now you get to find out what’s in it!!

  4. But the most obvious alternative they have is to step aside and allow the federal government to run the exchange directly, which may be even less appealing.

    But the less obvious but more sensical and moral alternative is straight NULLIFICATION.

  5. the creation of these new insurance marketplaces will entail a fair amount of political controversy in addition to implementation headaches.

    So apparently one of the first things we will get out of the new Health Care legislation is headaches?

    Well done Democrats.

  6. I’m not so sure why a state would want to step in and run what is sure to be a world-class clusterfuck, when it can just stand aside and let the feds incur the expense and take the beatings.

  7. Leighton Ku, professor of health policy and director of the center for Health Policy Research at The George Washington University, said that many of the state estimates of cost are overblown. And even if they are on par, the federal government taxpayers will end up paying a significant majority of the increase, he said.

    The professor made a little mistake, but I fixed it for her.

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