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ObamaCare State Exchanges - Archive History of Exchanges

Final Talley: 26 States Opt Out, 6 Partner and 18 States Accept the Full Obamacare

Brewer rejects state-run health exchange for Ariz.  (WE DID IT!!)

by Paul Davenport, Associated Press

Posted on November 28, 2012 at 3:25 PM

PHOENIX (AP) -- Arizona Gov. Jan Brewer has decided against creating a state-run health insurance exchange required to implement a key part of President Barack Obama's federal health care law.

Brewer's decision announced Wednesday means the federal government will set up an online marketplace for the state, offering subsidized private health coverage to the middle class.

Brewer, who reiterated her opposition to the health care overhaul, said there are too many costs and questions associated with a state-run exchange.

Federal requirements mean the state "would wield little actual authority over its `state' exchange," she said in a statement.

"The federal government would maintain oversight and control over virtually every aspect of our exchange, limiting our ability to meet the unique needs of Arizonans and the Arizona insurance market," she said.

Brewer sent a federal official a one-page letter disclosing her decision.

Her announcement preceded a Dec. 14 deadline for states to declare whether they'd run their own exchanges.

A decision to create an exchange would have been subject to approval by the Republican-led state Legislature.

Though the Nov. 6 election results reduced the size of Republicans' majorities in the state House and Senate, a Brewer push to create a state-run exchange would have faced a fight from GOP lawmakers who oppose the law.

An alliance of hospitals, insurance companies and business groups wanted Arizona to have a state-run exchange, arguing that it would increase coverage while giving the state flexibility in designing a program to its liking.

Conservative advocacy groups such as the Goldwater Institute stand in opposition. They say Arizona shouldn't help implement a law that could foist new expenses on the state and raise health insurance prices for residents.

Brewer's administration spent two years planning for a possible exchange, accepting approximately $31 million of federal funding to pay for the advance work.

As part of that planning, Brewer in September selected a minimum benefits package for a state-run exchange based on current insurance coverage for state employees. She noted in a Sept. 28 letter to the Obama administration that the package she chose excludes abortion coverage.

While some Republican governors in such states as Texas and Maine have balked at creating state-run exchanges, others in Nevada and New Mexico have opted to proceed.

On another implementation issue with state versus federal considerations, Brewer has decided it was better to have the state run its own program to review health insurance rates, rather than leave that to the federal government. The state has formally approved rules for a rate-review program.

Brewer still must decide whether to expand eligibility for the state's Medicaid program as called for by the law.

© 2012 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.


Obamacare Insurance Exchanges: States Have Options

Nina Owcharenko and Edmund Haislmaier

November 20, 2012 at 10:43 am

Governor John Kasich (R) is expected to opt not to set up a state Obamacare exchange. This is the right decision for Ohio. The President’s health care law is unworkable and unsustainable. Rejecting the health insurance exchanges, and equally as important, the Medicaid expansion, are two opportunities states have to push back on this law and instead push forward on a better health reform agenda for Ohio.

These exchanges are used in the law to funnel subsidies to government-controlled health plans. Some proponents of the law will undoubtedly criticize the Governor’s decision. But, there are more practical and sound reasons why opting not to adopt a state exchange is best for the states.

First, under the exchange regulations promulgated by the Secretary of Health and Human Services (HHS), states would gain no meaningful flexibility or advantage by operating their own exchanges, relative to a federally facilitated exchange. They would simply be acting as vendors to HHS.

Second, states still regulate insurers (including those participating in exchanges) in all matters not otherwise preempted by federal law, regardless of who operates the exchange. States can also regulate exchange “navigators” through state professional licensure statutes, to ensure equal standards/level playing field with other insurance producers, again, regardless of who operates the exchange.

Third, electing to operate the exchange means that the state government is voluntarily taking responsibility for the results, along with the obligation to secure the necessary operational funding. While the Obama Administration is encouraging states to commit to establishing a state exchange, there are numerous, important details still unknown. Every day that goes by with no roll-out of these vital pieces by the Obama Administration further increases the probability that the Administration is not ready and will fail when the exchanges are expected to open in October.

Fourth, a state that elects to let the federal government set up the exchange can—if it doesn’t like the results—set up a state exchange to replace the initial federal exchange later. There is no rush to commit.

The next big decision for Governor Kasich will be whether he also rejects the Medicaid expansion. Here, too, there will be many who will try and argue why Medicaid expansion is a good idea. But the promises of no cost, more control, and helping those without health insurance fall flat. The Medicaid expansion will bring long-term costs to the states, offer no new flexibility to the existing Medicaid program, and create greater dependence on government-run health care rather than less.

Health care reform is important, but recognizing a failing solution is even more important. Governor Kasich deserves tremendous credit for recognizing the shortfalls of the Obamacare exchanges and, hopefully, he will come to the same conclusion with the Medicaid expansion. Likewise, instead of acquiescing to a flawed law, states like Ohio can lead the way to the right health care solution.

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The SCOTUS decision on Obama care gives the states the opportunity to opt out of the Health Care Exchanges and the increases in Medicaid by adding thousands more on the medicaid rolls. Several Governors have already said they were not going to participate in either one, Gov.  Rick Perry being the last to say no. 

Our Governor, however, has accepted and spent over $70 million to set up these exchanges and has had her team of czars working furiously on getting them done.  In order to perpetuate the exchange, however, the legislature has to vote to accept the exchanges and agree to fund them in the future.  

You would think that because Arizona was one of those states that sued the Obama administration because the individual mandate was unconstitutional the Governor would NOT have taken the money and would be one of the first to tell the feds “Arizona will not participate.”  Not so!! In fact, she is all for it, as are the states insurance companies.  In fact, she is trying to determine if she really needs to bring it before the legislature at all!!!  So your state  tax dollars could be used to fund the exchange without YOUR elected representative having a say— isn’t that what started the TEA Party in 1773 in the first place??

We need to FLOOD her office for the next few weeks with calls, emails and especially our bright Yellow Post Cards telling her to stop the exchange and back out of the whole process.  The people of AZ voted NOT to participate in Obamacare in 2010 and made it an amendment to the Arizona Constitution. Brewer has ignored that public voter mandate and took the money to set up the exchanges. That is what dictators do!!!.  We did not elect her “dictator”-- Jan Brewer works for us.    
The decision by John Roberts and SCOTUS was unconstitutional regardless of how the decision came out.  The Supreme Court does not always get it right and they certainly got it wrong this time.  Under the 9th and 10th Amendments we need to exercise our sovereign states rights to nullify this decision by the court and the whole idea about a universal health care system that will tax every one just because they are alive.  The result of this decision is the majority of people who make under $120,000 will bear the brunt of the taxes for this unconstitutional plan.  There are other solutions and those solutions belong to the states NOT the federal government.

Here is the Governors contact information:
Mailing address:                                  Phone and Fax:

The Honorable Janice K. Brewer            Phoenix Office:   (602) 542-4331
Arizona Governor                                 Tucson Office:     (520) 628-6580    
Executive Tower                                   Fax Number:       (602) 542-1381
1700 West Washington Street              In-State Toll Free:    1-800-253-0883
Phoenix, AZ 85007
On line contact information:  

Brewer held meetings with "stakeholders" back in July to decide whether to continue with the Healthcare Exchange.  No where in her list of "stakeholders" is a single taxpayer on whose back this whole thing rests.  Send your postcards and let her know that the ONLY people she should be talking to are those who are going to pay the bills--YOU!!!

Read her comments here:

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