On Friday, Joel Ario, the Director of the Office of Insurance Exchanges at HHS reiterated his claim that regulators on the state level are far more open to implementing the exchanges in the Affordable Care Act than the current political rhetoric suggests. Speaking at a panel for the Alliance on Health Reform, Ario said “that there was a lot of interest on the state level in these exchanges and that it was very focused and very specific to the fact that state markets are broken.” “It’s hard to see who’s from a red state or a blue state, you just see people who are working in their marketplaces trying to put things together.” Watch it:
Washington and Lee University law professor Tim Jost, also a member of the panel, reiterated that the idea behind an exchange “comes out of free market advocacy groups and has been endorsed by them in the past. The particular way it is shaped, we’ll see blue states taking one approach and red states taking one approach, maybe,” he stressed, referring to the two existing exchange models in Massachusetts and Utah. Blue states may follow California’s lead and adopt the Massachusetts model, which allows the authority that governs the Exchange to bargain with insurance companies on behalf of consumers and requires issuers to meet certain minimum standards. Red states, conversely, may consider the Utah model where consumers can “compare a wide variety of health plans sold by any insurers that want to participate.”
Ario also added that he first heard of exchanges from a Republican legislator in Oregon, “who had a concept paper from Ed Haislmaie at the Heritage Foundation. I followed the idea for several years there, as it made its way through the Heritage foundation. They took credit for getting Governor Romney to support the idea in Massachusetts and to date, the three states that have exchanges have all been led by Republican governors.” (Click here to read Haislmaie’s article praising the exchanges and the individual mandate.)
Heritage may now be downplaying its support for the concept, but the exchanges are still fairly popular in conservative states. Last month, for instance, 48 states — 21 of which are suing the federal government over the constitutionality of the Affordable Care Act — accepted federal grants “to invest in research and planning to get the Exchanges up and running” by 2014.