Texas is joining the ranks of states like Indiana, Mississippi and Alabama in implementing key sections of the Affordable Care Act while challenging the the constitutionality of the measure. The Texas Tribune’s Emily Ramshaw is reporting that for all his anti-reform rhetoric, Gov. Rick Perry (R-TX) has given state health officials the green light toward enacting a state-based exchange — a new insurance market place established by the Affordable Care Act that will allow residents to compare and purchase insurance coverage beginning in 2014. Under the reform law, any state that does not build its own program will be required to hand over its operations to the federal government:
[O]fficials at the Texas Department of Insurance acknowledge that since last fall, with the help of a $1 million grant from the United States Department of Health and Human Services, they have been working quietly to plan for a health insurance exchange.
“We’ve been going full speed ahead on implementation, doing the due diligence so that we can be on time with what the law says,” said John Greeley, a spokesman for the agency.
Lucy Nashed, a spokeswoman for Mr. Perry, said the governor is aware of the grant, which she said is exploratory and does not require Texas to set up an exchange. While Mr. Perry prefers local solutions to Texas’ health care problems, Ms. Nashed said the governor remains hopeful the courts will overturn the federal health law. “The governor’s firm belief that Texans should be in charge of our health care programs is unchanged,” she said.
Republicans are trying to avoid greater federal interference; they can’t be running around the state saying the federal government wants to take it over and then pass on an opportunity to mold a state-based exchange that reflects their free market ideology. But there is a certain schizophrenic undertone to the states that are politically condemning the law while privately implementing it. That will bring new challenges as they work through the complex reforms and establish new consumer protections and regulations.