Health care reform stalls out in previously supportive states

Federal health care reform is facing more hurdles, this time with states that agreed to move forward implementing requirements before a Supreme Court ruling on the law. Some lawmakers and health insurance advocates in Pennslyvania are pushing back on the state’s plan for its health insurance exchange saying that as currently written the plan skews favorably to insurers. In Ohio, the two appointees in charge of health care in the state have opposing views of the law and are sending mixed messages to lawmakers.

Federal health care reform has been controversial since it was first introduced. Upon its passage, several states mounted legal opposition claiming that the bill was too costly to implement at best and unconstitutional at worst. Some of those challenges have had limited success, the Supreme Court is expected to take up the issue and make a final ruling later this year.

Some states however, moved forward with implementing requirements as passed. Now, in a few of those states implementation is facing new hurdles as both advocates of the law and its critics raise questions about how the law is managed in practice.

Pennsylvania is moving forward on plans to create a health insurance exchange, one of the key state level requirements of health care reform. Even before health care reform required the creation of an exchange the state was aggressive in monitoring and challenging insurance rates and coverage in the state. Observers felt that the health insurance exchange would further codify this process and put more power in the hands of consumers.

However, once the plan was released insurance exchange supporters have lambasted state government saying that the plan is a giveaway to insurance companies. According to a piece in The Morning Call, leaders of the Pennsylvania Health Access Network, a coalition of health reform supports are saying that the plan as written favors insurers and will not provide any more affordable options for consumers.

Pennsylvania Governor Tom Corbett has asked the federal government for $33 million to implement a state run exchange, but his plan shows multiple privately run exchanges. These exchanges would be managed more by the insurers themselves than as an overarching state run exchange. As CivSource noted last year, some insurers already have a running start on this, WellPoint is creating its own privately run exchange to compete with federal and state managed exchanges. Governor Corbett filed for a challenge to the law when he was attorney general, and critics of the plan cite the multiple exchange concept as a way of letting corporate insurers retain control of the marketplace while still filling the exchange requirement.

In Ohio, consumers and lawmakers are facing similar top-down mixed messages on how to implement health care reform. Governor Kasich has been on record opposing health care reform since the law was passed. However, his state also moved forward on plans for an exchange and other requirements in order to guard against ‘federal takeover.’ Now, the state’s two key health care appointees are locked in a battle on implementation as one supports health care reform and the other does not.

The Mansfield News Journal is reporting that the state is taking a two track approach to health care reform requirements: moving forward on some while simultaneously stalling out on others until the Supreme Court ruling.

Greg Moody, leader of the Office of Health Transformation is using guidance from health care reform to focus in on creating preventative care initiatives and finding ways to lower the cost of health care statewide while improving service delivery. On the other side, Lt. Gov. Mary Taylor, who heads Ohio’s insurance department, has called health care reform a “catastrophic law,” and is doing everything she can to halt its implementation by boycotting the law through the Department of Insurance.

Ohio is part of the group of states challenging health care reform at the Supreme Court. For her part, Taylor has already returned a $1.3 million grant won in Governor Ted Strickland’s administration in order to provide consumer’s with information about their rights to insurance and how to file complaints. She has also indicated that her department will not be applying for or accepting any new funding to implement health care reform requirements – including a health insurance exchange currently being debated in the state legislature.