In the new health insurance law Congress passed, there is a mandate that all states must have an insurance market exchange operating by January 1, 2014. Further, on or before January 1, 2013, if the Secretary of Health and Human Services determines that a state will not have an exchange ready by January 1, 2014, the Secretary shall establish and operate the exchange for that state.
Even more significant, States cannot request a waiver to set up a different plan until 2017. There is no wiggle room here. There is no opt-out language. This is a clear mandate that exchanges be established in every state by 2014. States are required to spend the time, money and resources to set up and operate the insurance exchange. They may choose to have one or two or more exchanges or set up regional exchanges. A single payer type plan or a public option with or without an exchange is not allowed. Thus, as things stand, states cannot experiment with an approach that is not based on the private insurance market exchange model until 2017, after they have set up an exchange or the federal government has set one up for them.
In a meeting this morning (Thursday, May 20) in Helena, Liz Fowler spoke. She is a member of the staff for the Senate Finance Committee and Max Baucus' lead staff person on health care. We asked about the 2017 problem and whether they could take action to move up to 2013 or earlier the opportunity for states to opt out.
Ms. Fowler said they had been working with Senator Bernie Sanders on an amendment to move that date up; this amendment would have been considered in conference committee where the House and Senate work out their differences in a bill. In the end, of course, no conference committee was used to pass this bill.
Ms. Fowler said she would check with Senator Sanders. She also said Senator Orrin Hatch was interested in moving the date because Utah wants to try their particular, private insurance approach. When asked how to make this date change important enough for it to happen, she said people simply needed to keep calling about it and talking about it.
Essentially, it is the "squeaky wheel" approach that is needed and everyone needs to take absolutely every opportunity to bring this issue up and support changing the date from 2017 to 2013 or earlier. Congress also needs to guarantee that the States which choose a different path still have access to the federal set-up and other grants as well as subsidies for premiums that states with insurance exchanges will receive.
Senator Baucus is literally flooding Montana with Congressional staff people right now to explain the health "reform" bill. If you hear of a meeting in your community, please attend and raise these issues (the date change and the guarantee of access to set-up funding). They need to hear about these from people all over the state.
If you do not hear about a meeting in your community, call one of Baucus's field offices or his D.C. office (202-224-2651) , send a fax to D.C. (202-224-9412- fax) or email him at
http://baucus.senate.gov/?p=contact. We might also thank Senator Sanders for his previous efforts and encourage him to forge ahead with a change in the date allowing states to opt out sooner and receive the federal set-up support, grants, and subsidies for premiums.
Sorry this is so long but the information is important and so is your action.
Thanks.
Montanans for Single Payer