With the last minute deadline changes and states still undecided on whether or not to set up their own exchanges, some may wonder why this is all coming down to the wire.
The explanation lies in the timing. The Affordable Care Act, or ‘Obamacare’, was signed into law two years ago, and set out a specific implementation time table for states to follow, but most don’t see it as that simple. Over the past two years there have been countless political battles over the law, including a supreme court ruling and a presidential election, all of which could have substantially changed the law and it’s implementation.
Even after the Supreme Court upheld the vast majority of the law in a challenge from 26 states, some of those states held out for the presidential election. Governor Romney vowed to delay or altogether stop the implementation of state health insurance exchanges, if he were to be elected.
Obama’s election victory and the continuation of a Democratic Party majority in the Senate guaranteed the survival of his health care law, however, and sent some states scrambling to meet deadlines less than two weeks away. According to the law, states were required to tell the Department of Health and Human Services (HHS) if they intended to operate their own exchanges, and to give specifics on how they would run those exchanges by November 16, 2012.
HHS first issued a letter after the election that maintained the November 16th deadline for states to report their intent, but pushed back the deadline to report specifics .Then, responding to a request from the Republican Governors Association, HHS on Thursday pushed back the deadline for states to report intent to match specific plan deadline on December 14th.
This gives time for the Obama administration to issue details on how a federally run insurance exchange would work before states make up their mind. Those details were also on hold until after the election.
Although the public remains divided about the health care law, the idea of states running the new insurance markets is popular, especially with Republicans and political independents. A recent AP poll found that 63 percent of Americans would prefer states to run the exchanges, with 32 percent favoring federal control.
The breakdown among Republicans was 81 percent to 17 percent in favor of state control, while independents lined up 65-28 percent in favor of states taking the lead. Democrats were almost evenly divided, with a slim majority favoring state control.
This article was written with information from a Washington Post article, found here.