Newspaper article Pittsburgh Post-Gazette (Pittsburgh, PA)

Feds Release Health Overhaul Blueprint for States 'Exchanges' to Offer One-Stop Shopping

Newspaper article Pittsburgh Post-Gazette (Pittsburgh, PA)

Feds Release Health Overhaul Blueprint for States 'Exchanges' to Offer One-Stop Shopping

Article excerpt

WASHINGTON -- Fifty million people in America lack health insurance, and the law says most of them must soon be provided coverage. But how to deliver?

The Obama administration on Monday finalized an ambitious blueprint for new state-based markets that will offer consumers one- stop shopping along the lines of amazon.com. It may sound simple enough, but getting there will be like running an obstacle course.

The rule comes just two weeks before the Supreme Court takes up a challenge to the constitutionality of the Patient Protection and Affordable Care Act in a case brought by states. Many governors and legislators are on the sidelines awaiting the outcome, even as time is running out to implement the law.

Starting Jan. 1, 2014, new health insurance markets, called "exchanges," must be up and running in every state, the linchpin of a grand plan to make health insurance accessible and affordable to those who now struggle to find and keep coverage. Individual consumers and small businesses will be able to shop online for competitively priced coverage, and many will get government subsidies to help pay premiums.

"More competition will drive down costs, and exchanges will give individuals and small businesses the same purchasing power big businesses have today," Health and Human Services Kathleen Sebelius said in a statement.

Experts say it's anybody's guess how the national rollout will go. If a state is not ready, the law requires the federal government to step in to run its exchange. But the Obama administration's request for $800 million to operate federal exchanges has gotten a frosty reception from congressional Republicans.

"At this point, it's still an open question as to whether all the states will open up as of 1/1/2014," said Neil Trautwein of the National Retail Federation, a business group whose members the law will greatly affect.

Reaction Monday to the 640-page rule was mixed. Consumer organizations, the insurance industry and some business groups gave it favorable or neutral reviews. Republican governors panned it.

The new markets are for individuals and small businesses buying plans. Most people who now have employer health insurance will not have to make changes. It's a design that works well in Massachusetts, where an exchange has been in place for several years.

Massachusetts achieved political consensus about its health care overhaul under then-Gov. Mitt Romney, who is now seeking the Republican presidential nomination. That's far different from the enduring national divisions over President Barack Obama's law, even though it used Mr. Romney's as a foundation.

Setting up 50 state exchanges wouldn't be easy even if the federal overhaul enjoyed widespread support. For things to go smoothly, state and federal officials must work together to verify private personal and financial details for millions of people, make sure that consumers are enrolled in the right health plan, and accurately calculate how much government aid, if any, each household is entitled to. …

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