A $26 million federal grant sits waiting to help Missouri build the information technology necessary to run a health insurance exchange and modernize its Medicaid program. But mistrust and obstinacy are preventing the state from accepting the money.
The Affordable Care Act signed into law in 2010 calls for states to design health insurance purchasing exchanges by 2014. Individuals and small employers will use the exchanges to find a plan that best meets their needs or to qualify for federal subsidies channeled through the state.
The new grant from the U.S. Department of Health and Human Services would enable Missouri’s Insurance Department to start working on the technology package for the exchange. The same computer system could be used to upgrade the archaic technology the state uses for its Medicaid program.
It’s clearly in the state’s best interest to accept the money and get started. But the toxic political climate that increasingly characterizes state government has prevented it from doing so.
Gov. Jay Nixon’s administration applied for the grant through a quasi-governmental entity, the Missouri Health Insurance Pool. Money spent by that entity isn’t normally subject to approval by the state legislature.
That move made sense.
Although the Missouri House unanimously approved a bill establishing a state-run insurance exchange last session, ideologues in the state Senate have vowed to block any measure that brings the state into compliance with “Obamacare.”
But legislators understandably want to know how the grant money will be spent and who will benefit. Officials from the Insurance Department did a poor job answering lawmakers’ questions at a hearing this week, which only heightened the mistrust between the executive and legislative branches.
Nixon is reluctant to wade into these kinds of spats, but he needs to help resolve the conflict. The governor must make sure legislative leaders know exactly what is going on with the grant and that contracts are awarded properly.
Time is of the essence. Federal law requires states to design their own exchanges or else use a model designed by Health and Human Services.
Either way, the state must update its infrastructure. Nixon needs to exercise leadership to get this important project on track.