[Lamplighter]

Today was the day ... Now to see what happens by 2014

Washington Post
Sarah Kliff
2/18/13

It’s official: The feds will run most Obamacare exchanges

Friday was a very important day for health policy days.
It was the last day for states to tell the federal government whether
they wanted any part in running the Affordable Care Act health exchanges come 2014.<snip>

All told, the federal government will run 26 of the state health exchanges.
It also will partner with seven states, where state and federal officials
take joint responsibility for the marketplace.
Seventeen states and the District of Columbia will take on the task themselves.
<snip>

The big question moving forward is: Does this split matter?
Is it better or worse for the federal government to be running
the majority of the state health exchanges?<snip>


In a way, all these states turning over their exchanges to the federal government
brings Obamacare a little closer to the more liberal House bill,
which had the federal government running one big marketplace.
It allows the White House to have more control over setting up its signature legislative accomplishment.
It also creates some economies of scale, as HHS can develop one
template exchange that all 26 states it handles will use.

That could be especially important in states where opposition
to the Affordable Care Act still runs very deep.
When I’ve talked to Democratic state legislators, in states where a Republican governor
has declined to build an exchange, they sometimes express a sense of relief.
If they put an Obamacare opponent at the helm of a crucial health law program,
it would be akin to foxes running the hen house.
What better way to sabotage health reform, after all, than doing a shoddy job
setting up the main vehicle for Americans to access health insurance?