INDIANAPOLIS – Gov.-elect Mike Pence has ruled out building a state-run health insurance exchange but appears to be leaving open the option of running a joint venture with the federal government as a critical decision deadline draws near.
State leaders have until Friday to declare whether they will manage their own programs for providing insurance plans under the federal health care law. And even though he won’t be inaugurated for another six weeks, Pence will provide Indiana’s answer to the Department of Health and Human Services under an arrangement outgoing Gov. Mitch Daniels worked out with this year’s gubernatorial candidates.
Pence, a longtime opponent of President Obama’s law, has said a state-run exchange would be too expensive and also has cast doubt on expanding the number eligible for Medicaid. But opposing a state exchange would not necessarily rule out a “hybrid” system of state control over federal resources, based on deadlines set by the Obama administration.
“It’s just one step at a time,” Pence spokeswoman Christy Denault said Wednesday. “Obviously, Mike has been clear on his positions.”
On the face of it, uninsured Indiana residents are unlikely to notice much difference between a federal health insurance exchange, hybrid plan or state-run system.
Any option would involve residents logging onto a website and selecting pre-approved health plans with basic amounts of coverage and, according to estimates provided by the state to Indiana’s gubernatorial candidates this summer, cost roughly $400 a month.
Open enrollment for exchange plans is scheduled to start Oct. 1, 2013, and coverage will be effective Jan. 1, 2014.
Pence’s opposition to a state-run exchange is smart politics, said Bob Laszewski, of Health Policy and Strategy Associates, a Washington-based firm advising health insurers on the new law.
If the Obama administration builds and runs an exchange, it would not only bear the costs but also the responsibility for any failures, he said. And if the exchange is a shining success, Pence can swoop in and take it over after a year, he said.
