Skip to comments.Why WI Gov. Walker refuses to implement a state-based health-care exchange
Posted on 11/21/2012 3:11:03 PM PST by Wisconsinlady
Dear Concerned Citizen:
On November 6, citizens across the state and country voted to reelect President Obama. As a result, the implementation of federal health care reform continues to move forward.
While I may disagree with the federal health care law, health insurance exchanges will now be built. To do so, federal law provides states three options: 1) create a federally run exchange; 2) create a state-run exchange; 3) establish a partnership plan requiring the state to administer the exchange for the federal government.
The most important consideration for me in deciding which option is best for our state is protecting Wisconsin's current and future taxpayers.
On November 16, I informed the U.S. Department of Health and Human Services (HHS) that Wisconsin will not build a state-based health insurance exchange and will defer to the federal government's insurance exchange.
Here are the facts influencing this decision:
1. The long-term risk to Wisconsin taxpayers is too high. If a state takes on the task of running the exchange, it also commits to long-term spending obligations from uncontrolled costs that are not fully funded. When federal funding dries up, costs for Wisconsin taxpayers would skyrocket under a state-run exchange. Putting state taxpayers on the hook for a program we cannot control is simply not responsible governance.
2. No matter who sets up and administers the exchange, the federal government makes all the decisions and the final product is the same. The federal health care law dictates to Wisconsin and to our health care providers exactly what policies and products may be offered in the exchange and elsewhere. Decisions regarding eligibility, minimum standard of coverage, and all other important details will be determined by our federal government. For instance, the HHS Secretary defines "qualified health plans" and the Secretary of the U.S. Department of Labor issues "best practices of plain language writing" for qualified health plans.
3. The federal government's demonstrated lack of cooperation and detail increases the burden and risk to our state. While there has been ongoing rhetoric that states will have flexibility in creating a state-based exchange, we have seen very little cooperation from the federal government on issues related to the implementation of federal reform. Thus far, HHS has provided little to no guidance on the impact of the U.S. Supreme Court ruling on the Medicaid elements and implementation.
4. PPACA does not allow for a uniquely Wisconsin option. In Wisconsin, we have been successful in providing health insurance coverage to over 90 percent of state residents without the creation of an exchange. Other states moving forward with state-operated exchanges have nowhere near our level of coverage. To preserve this, we would all like to build a uniquely Wisconsin exchange, but the reality is the federal health care law simply doesn't allow it. Whether an exchange is administered by the state or the federal government does not change the fact the federal government will set uniform policies for all states. Utah's state insurance exchange further demonstrates this point. Utah had an established insurance exchange prior to the enactment of federal reform. As a result, the state has submitted their exchange to the federal government in an effort to meet the insurance exchange requirement. Rather than demonstrating a willingness to work with the State of Utah, the federal government simply directed the state to go back to the drawing board.
In the end, the only real difference between the three options is the potential cost to taxpayers, which made our choice clear. As a result of our decision, Wisconsin taxpayers and consumers will have access to the same products without the risk of having an extra burden placed upon them at a time when they can least afford it.
To read my recent op-ed about my position on health insurance exchanges, please click here.
Governor Scott Walker
This guy has giant brass ones. More govs should follow his example.
Wisconsin No Healthcare Exchange Ping
FReep Mail me if you want on, or off, this Wisconsin interest ping list.
So in these states where governors are giving the feds the bird, does that mean citizens are gonna get hosed by the feds for not having gov approved insurance since they won’t be able to buy any on the exchanges?
I would bet that the federal government itself doesn’t know what it wants for these exchanges and that in the end they will push off the exchanges while they get their act together. Should be interesting as I’m sure HHS was relying on the States to set these up and does not have the manpower to do it themselves.
Why should they spend billions of tax dollars to figure all that out, go to court when the DOJ sues them, etc.?
Let the Fed Gov't take the blame for the confusion which will ensue going forward, not the States.
Au Contraire, Mon Ami.
The Gubmint knows EXACTLY what they want, and they bought the Election with the idea that all those on Welfare and Government-Dependency VOTED for The Messiah BECAUSE it was "Free Medical Care" for them, since they would be given coverage without paying a dime, at the expense of PAYERS. Now, inner-city-tribal parasites and the soon-to-be-granted-Amnesty Illegals will be riding free on your earnings for Medical Coverage.
They ALL voted for The Messiah to get more freebies, and it's all about POWER, WEALTH-REDISTRIBUTION, and buying votes with taxpayer money.
maybe you are right. Just seems to be punting away the last bit of power states have in the game.
But as I (roughly) understand it, ther are at least two reasons why the states should opt out:
“So in these states where governors are giving the feds the bird, does that mean citizens are gonna get hosed by the feds for not having gov approved insurance since they wont be able to buy any on the exchanges?”
No. The effect of not having a state exchange is that the feds create an exchange in that state. The feds have to pay for the federal exchange. The states have to pay for the state exchange (after a brief period in which the feds take up the cost).
There is also a good argument that the employer penalties under Obamacare cannot be enforced in a state unless there is a state exchange.
I forgot the /sarc tag.
Please supply a link so we can leave this in news.
Also a link to his op-ed.
Good job, Walker. Do you have the link to his OpEd?
I agree. They are allowing the Fed to go ahead.
I agree they allowing the Fed to go ahead with its plan, but Walker gave the reason. He said that the Fed will reject anything that isn't exactly what they want, anyway, as they have done with Utah, for example.
IOW, you are getting the Fed plan no matter what you do. However, if the state is running the fed plan, then the state will get stuck with ALL unfunded liabilities, additions, etc.
Since it's going to be the Fed plan anyway, might as well let them be solely responsible for paying for it.
I can see his point.
no linky, no newsy. Not even a blog link!
Walker is right. It is ridiculous for the state to accept the responsibility for the exchange without having control of it.
Let all the states fund it instead of only WI. He is looking after the state’s citizens. That’s his job.
"In the end, the only real difference between the three options is the potential cost to taxpayers, which made our choice clear."
I love this guy. Walker is a real Republican, and a governor who puts the people who work and pay taxes ahead of the Democrat moochers. I don't know why there hasn't been more talk about Walker as a rising GOP star who deserves a shot on the national stage. I guess the GOP establishment elite doesn't like him? Is he too conservative for that pack of useless scum?
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