Health Insurance Exchange Stalling Final Budget

It feels like the movie Groundhog Day.

You remember the ’80’s movie starring Bill Murray in which the main character wakes up every morning and lives the day over and over and over and over…

Arkansas lawmakers keep referring the state Insurance Department bill for a vote in the House intent on finding 75 voters to pass the controversial bill. Thus far, 70 has been the most votes it can find on two separate occasions.

We’ve documented what happens if the agency’s budget doesn’t pass, and the hold-up is over an unpopular provision of the federal health care law that the Insurance Department will oversee: health insurance exchanges.

As we’ve noted, there is a $1 million line item in the insurance agency budget that a sizable minority of Republicans and one Democrat want stripped out. It is federal money that the state will use to plan its health insurance exchange, which must show planning progress by Jan. 2013 and be operational by Jan. 2014. Opponents of health care reform argue that the state can wait to move on this exchange pending the fate of federal health care in the U.S. courts or Congress.

Supporters of the exchange say they’ll cancel plans if health care reform is halted, but that the state needs to move forward now. Those proponents adopted an amendment in a House bill that lays out some regulatory parameters for creating the exchanges that would nix the spending under those circumstances.

Thanks to a frequent reader, we share a story from The Washington Post that answers a number of questions about how state health exchanges would work under the federal law and how different states are handling their exchanges in different manners. Some questions answered in the article include:

• What is an exchange, as envisioned by the health-care law?
• Will all states have exchanges?
• Will anyone be allowed to buy from the exchanges?
• Will exchanges be like travel Web sites or some existing health insurance sites?
• What will the coverage sold on the exchanges look like?

And finally: Will all state exchanges be the same?

No. States can design their exchanges differently, an issue that’s sparking debate in statehouses nationwide. Some states may choose to set additional standards for insurers beyond the federal law. Another important issue: The makeup and power of the governing boards overseeing the exchanges. Some states, such as Maryland, are considering barring insurance industry and sales agents from their governing boards. Others, such as North Carolina, have legislation pending that includes representatives from those groups on their governing boards.

This article, which you can read here, is unlikely to cause a breakthrough in the capitol budget battle, but it does offer readers a bit more information on the subject that is causing such strife under the dome.