Missouri Senate backs measure blocking health exchanges

Tuesday, January 24, 2012 | 8:36 p.m. CST

JEFFERSON CITY — Missouri's Republican-led Senate endorsed legislation Tuesday aimed at preventing the state from implementing part of President Barack Obama's health care overhaul.

The federal health care law gives states until 2014 to either set up their own insurance exchanges, which allow consumers to shop online for health insurance, or have one run by the federal government. The legislation, given initial approval Tuesday, would block Democratic Gov. Jay Nixon from creating an exchange by executive order, instead requiring legislative or voter approval before Missouri could take steps to set up an insurance exchange.

Debate focused on a provision that would prevent state departments from receiving or spending any federal money to begin setting up the exchanges unless the legislature votes to create one. Sponsor Sen. Rob Schaaf, R-St. Joseph, said the measure would assure that Missouri lawmakers remain in control of the state's finances.

"I believe that the sovereignty of our own state over spending money takes precedence (over the federal law)," he said. "The federal government can't tell us how to spend our money."

If the bill passes both the House and Senate, the legislation would go before the voters in the November election. Schaaf said voters would likely support his legislation, citing the August 2010 elections, in which 71 percent of Missouri voters cast ballots repudiating a key part of the federal health law that requires most Americans to purchase health insurance or face penalties.

Several Democrats opposed Schaaf's measure, saying it was simply ceding control of a health insurance exchange to the federal government.

Sen. Jolie Justus, D-Kansas City, said it is unlikely that both the House and Senate would come to an agreement on how to set up an insurance exchange before federal health officials begin setting one up as allowed by the 2009 federal law. She challenged Schaaf's sovereignty argument, saying his legislation means the state will have little say about a health insurance exchange that will soon be operating in the state.

"The train is coming at us, barreling down on Missouri," she said of the looming federal deadline. "And we're just standing there."

A measure aimed at legislatively implementing a state health insurance exchange unanimously passed the Republican-controlled House last year, but failed to come to a vote in the Senate. Supporters of that bill said the U.S. Department of Health and Human Services also has to approve of the state exchange's setup, meaning the state would need to have the exchange in place sometime in 2013. Supporters said setting up the state's exchange would require negotiations with health insurance companies that could take up to a year.

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