Heineman will have to decide, by Friday, whether or not Nebraska will create its own Health Care Exchange under ObamaCare, or cede that authority to the Federal Government. The split on this issue is about the same as it was a few months back.
Many had hoped the states’ Governors wouldn’t have to make this call if Mitt Romney was elected President. That changed last week. As Mike Johanns has said, ObamaCare is the law of the land. You don’t have to like it. But you, and the Governors, DO have to follow the law.
So the question of state Exchanges is the next big thing. Basically it’s this: If you don’t have health insurance, you’ll need to buy it. One of the ways for it to be available will be through a government run Exchange (via a website or other means) that will basically allow you to shop for various plans and purchase one.
But here’s the thing. The state can run the Exchange, and everyone in the state who needs to buy through the government site will use that. Or, the state can decide to let the Federal government run the Exchange, and everyone in the state who needs to use will go by that method.
But here’s the deal: This is all just beginning. There are bound to be hiccups in the system: problems, issues and loads and loads of whatnot. Some Exchanges are going to do a better job than others. People will be learning all along the way.
So the question becomes, who would you like to go to if there is a problem in the system? Someone from Nebraska or someone in Washington, D.C? Would you like to get assistance in Lincoln, or from some federal building half a country away?
Who is likely to adjust to nuances in Nebraska? Who will know the differences between someone in Alliance and someone in Omaha? Who is more likely to care?
Who is more likely to set up a system that meets the needs of Nebraskans? Someone in DC or someone in Lincoln? (That’s whatcha call one a them rhetorical questions.)
Now some of the Tea Party groups argue that only big insurance companies and big health care and people who want to profit want the Nebraska Exchanges. And they are certainly involved.
And…uh…so what? That facts remain the same. Either you pick Nebraska to do it or you pick the Feds. Those are your choices.
The Tea Partiers have some sort of argument that goes, If you let the Feds do it, they will screw it up and run out of money and pretty soon, Voila! No more ObamaCare!
Yeah. Because if we know anything, the Federal Government won’t throw more and more money at something they’ve screwed up. No, they’ll just close down the new bureaucracy, throw up their hands and say, “Whoops!”
So here is a list of some groups and companies and people who are in FAVOR of a Nebraska based Exchange:
Ameritas Life Insurance Corp.
Anthony C. Buechler, Buechler Insurance Services
Baltzell Insurance & Consulting
Benefit Administrators, Inc.
Bettenhausen Insurance Services, Lincoln
Blue Cross and Blue Shield of Nebraska
Bob Grundman, Senior Benefit Strategies
Dr. Bob Rauner, MD, MPH, Lincoln
Cherry County Hospital, Valentine
Garvey & Associates Grace
Grace/Mayer Insurance Agency
Greater Omaha Chamber
Harold Krueger, CEO, Chadron Community Hospital
Independent Insurance Agents of Nebraska
J.J. Green, President, Primark Insurance Agency
Kelly Cormaci, RHU, NP Dodge Insurance
Kolterman Agency Inc, Seward
Kutak Rock LLP
Les McGerr & Company, Lincoln
Marcotte Insurance Agency
Mary Ann Borgeson, Douglas County Commissioner
Midlands Financial Benefits
Mueller Robak Law Firm
National Association of Insurance & Financial Advisors – Nebraska
Nebraska Academy of Family Physicians
Nebraska Association of Health Underwriters
Nebraska Association of Home and Community Health Agencies
Nebraska Center for Healthy Families
Nebraska Dental Association
Nebraska Hospital Association
Nebraska Medical Association
Nebraska Nurses Association
Nebraska Nurse Practitioners
Nebraska Optometric Association
Nebraska Organization for Nurse Leaders
Nebraska Pharmacists Association
Nebraska Physical Therapy Association
Paul Utemark, CEO, Fillmore County Hospital
Preferred Marketing Associates, Omaha
Ray Pilakowski, Columbus
R.C. Schropp Associates
Scott Stevens, NP Dodge Insurance Agency
Stefano Tarantolo, MD
Steve Albin, President, United Benefit Services, Inc.
Swartzbaugh-Farber & Associates, Inc.
Terrie Spohn, APRN, FNP-BC, Multi-State Reimbursement, Alliance
Wells Fargo Insurance Services USA, Inc.
And another to add to that list: Nebraska Taxpayers for Freedom
And while there are Republicans and Democrats who favor a Nebraska Exchange, there are still vast differences between them on how it should be set up within the state (and who should run it). So if your goal is to fight with Democrats, there is still plenty to fight about.
But the fight about whether ObamaCare is the law is over. Now the question becomes, who do you want to run it?
We just don’t find the answer to that question to be very difficult.
From Don Walton’s interview with Governor Dave in the LJS:
He’s all-in for Lt. Gov. Rick Sheehy’s 2014 gubernatorial bid and will campaign for him as well as share his own extensive campaign contributor list.
A “big-idea” tax reform proposal designed to make Nebraska more competitive for job creation and economic growth is being carefully formulated, and “everything is still on the table,” including the possibility of eliminating the state income tax.
When Black Friday comes are you going to camp out on a sidewalk all night to get the $8 waffle iron? Or are you the smart and savvy shopper who will go through Amazon.com to get the great deals? Yeah, we thought so.
So when you do, click through our Amazon banners and send a little anonymous love to Leavenworth Street. Thanks for helping up keep the light on.
**UPDATE 11/15/12 2:15pm**
Statement from Governor Heineman:
Gov. Heineman on Federal Health Care Law: $646 Million State Exchange Too Costly
State of Nebraska to Participate in Federal Health Exchange
(Lincoln, Neb.) Health Insurance Exchange (pdf) – Gov. Dave Heineman today announced that he has submitted Nebraska’s affirmative election to participate in the federal health insurance exchange, citing the extreme cost differential that ultimately the Nebraska taxpayer would have to incur.
“I want to share with Nebraskans that I have listened to all sides of this issue,” said Gov. Heineman. “As Governor, my focus is on implementing the federal health care law in the most efficient and cost effective manner for Nebraskans and their families.”
Whether a state runs a health exchange, or that is done by the federal government, all citizens will have the option to purchase insurance policies through an exchange. A state decision either way does not affect that access.
The Governor appreciates the input he received from a variety of perspectives throughout the course of the several years since the federal health care law was enacted in March 2010. While there were diverse and emotional opinions on this issue, the Governor stated that his decision is based on what is best for Nebraska’s hard-working, middle class taxpayers.
Fiscal analysis of budget impacts done by the Department of Insurance and the Department of Health and Human Services calculate the cost of a state insurance exchange for Fiscal Years 2013-2020 at $646 million; while the cost of a federal insurance exchange is $176 million. The cost of a state exchange to Nebraska taxpayers is $470 million more than a federal exchange.
The analysis encompasses costs associated with building, managing and maintaining a state-based exchange. These costs include, but are not limited to: website development, call center operations, an insurance premium billing system, staffing, equipment, supplies, office space, and the technology costs related to each of these functions. In addition, these costs include expenses necessary for the exchange to interface with the Medicaid program, in accordance with requirements of the federal law.
“The reality is that the federal health care law is being totally dictated and totally controlled by the federal government,” the Governor added. “On the key issues, there is no real operational difference between a federal exchange and a state exchange. A state exchange is nothing more than the state administering the Affordable Care Act with all of the important and critical decisions made by the federal government.”
The Affordable Care Act calls for the creation of health insurance exchanges, state-run or federal-run markets where households and small businesses can shop for private coverage. Governors have a Nov. 16 deadline to indicate their intent to establish a state-based exchange. If a state does not elect to run a state-based exchange, then the health exchange will be implemented by the federal government.
According to the federal law, open enrollment is scheduled to begin for health exchange plans Oct. 1, 2013. Any exchange is expected to be fully operational on Jan. 1, 2014.
Oh well. Whaddaya gonna do? We always figured the price of the whole thing was going to be a big consideration.
At least the Governor pissed off Jane Kleeb again.