Obama Health Care – Exchanges Launch Soon, Nation Split Between State and Federal Control



By January 14 of 2014, states will either offer health insurance through state-run exchanges, or default to federal control under Obama health care.  As the Boston Herald says, American consumers will be the guinea pigs in the experiment to see whether the “feds” or state will do the best job in getting those individuals in the U.S. who currently do not have health insurance coverage.


According to the article, at the current time the U.S. is fairly evenly split between states that defaulted to federal control (mostly Republican-led states), and those which chose to have state-run exchanges (mostly Democrat-led states).  The states which have chosen to “default” to federal control essentially do not want to participate in Obama health care.


Purchasing health insurance isn’t an easy task for individuals who don’t have the money; the article goes on to say that under Obama health care, buying coverage through exchanges will make the experience similar to picking health careshopping on sites like Amazon.com.  Additionally, it is predicted that individuals who are not covered by their employers will flock to the health exchanges, and that the government will assist those in the middle-class with payment of premiums in many cases.


Obama health care will also send low-income individuals who cannot buy coverage in the direction of Medicaid and other programs considered “safety nets.”


Robert Krughoff, president of Consumers’ Checkbook, says that essentially, the health care exchange component of Obama health care is “an experiment between the feds and the states, and among the states themselves.”  Krughoff has serious doubts that either will make the selection of health care coverage as easy as choosing a hotel and travel package.


Come October 1st of this year under Obama health care, consumers will being signing up regardless of whether all of the kinks get worked out.  Coverage will take effect January 1, 2014, the same day that two other provisions of Obama health care take effect – the rule that insurers must provide coverage regardless of individuals’ health or pre-existing conditions, and the mandate that nearly all Americans have health coverage or face a penalty.


free statesSo far, 26 states have defaulted to the feds, and 23 states in addition to Washington, D.C. have chosen either state-run exchanges or are partnering with the Obama administration to run their own markets.  Already, states which have chosen to set up their own exchanges are taking very different paths; while some have chosen to open their markets to nearly all insurance providers and let consumers choose which one they prefer, others have chosen to “drive bargains” by offering only a limited selection of insurance providers.


According to a recent AP poll, 63% of Americans prefer state-run exchanges versus 32% who would rather yield to federal control.  Spokeswoman for Governor Rick Perry, Lucy Nashed, stated that “Texas is not interested in being a subcontractor to Obamacare.”


It will be interesting to watch over the next year to see how Obama health care fares in regard to health exchanges, and the differences between states which choose their own state-run markets, and those which default to the feds.  Will choosing insurance coverage really be as easy as going to Amazon.com and buying a book?  Only time will tell.  One thing is certainly clear; the confusion doesn’t seem to be subsiding, but hopefully as the changes are implemented it will become easier for Americans to understand, choose, and afford the coverage they need.


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