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Columbia Missourian

MU report warns about state law banning cooperation with federal health exchange

By Fedor Zarkhin
January 27, 2013 | 6:00 a.m. CST

COLUMBIA — An MU report submitted to the legislature Wednesday warns about the potential effects of a recently enacted law that restricts state agencies from working with a federal insurance exchange.  

The goal of the ballot measure was to put the decision to create a health insurance exchange in the hands of Missourians and their legislators as opposed to the federal government or the governor, said Sen. Rob Schaaf, R-St. Joseph, who sponsored the bill.

More than 60 percent of Missouri voters favored the measure, according to the Secretary of State's election results.

"The decision on whether or not to have a health insurance exchange changes the fabric of society," Schaaf said. "It's a major change in the way we do business, and it's not something that should be decided by one person or the federal government."

The health insurance exchange, which is one of the components of the Affordable Care Act, is intended to provide a way for people to compare insurance prices through one service, according to information on States had the option of setting up their own exchanges, but Missouri missed the deadline to do that and will therefore have a federally implemented health insurance exchange.

The exchange will allow individuals and small businesses to compare insurance plans side by side, which will spur competition among providers, according to the U.S. Department of Health and Human Services.

Another goal is to create ease of access to information about Medicaid and tax credit eligibility, according to the Kaiser Family Foundation.

The federal exchange will be implemented in January 2014.

But because of a provision on a ballot passed by Missouri voters in November, Missouri state agencies are now barred from cooperating with a federal insurance exchange program unless approved by an enabling statute. The ballot also forbade the governor from creating an exchange through an executive order.

Bridget Kevin-Myers, a research assistant professor at MU's Harry S Truman School of Public Affairs, believes that because of the ballot measure, it's unclear what health insurance policies will be available on the federal exchange.

In the report she submitted to two House committees and a Senate committee, Kevin-Myers predicted that the ballot measure will have a "chilling effect" that will make state employees wary of cooperating with the federal health insurance exchange. Because every health insurance plan in Missouri must be approved by the director of insurance, Kevin-Myers wonders whether any plans will be available on the exchange at all.

Kevin-Myers also believes the ballot measure will cost Missourians tax money because of a potential federal lawsuit against the state. Due to the preemptive rights of the federal government, the state is likely to lose, she said. But the cost of litigation will be passed on to Missouri taxpayers.

Rep. Stephen Webber, D-Columbia, believes Schaaf's bill was part of the Republican Party's general antipathy toward the Affordable Care Act.

"It's pretty hard to argue against consumers having access to information about a product they're going to purchase," he said.

The real goal of the ballot measure, Webber said, was political.

"They would rather Missourians not have cheaper health care than to see Obama succeed," he said.

Schaaf explained, however, that it wasn't the merits or demerits of a health insurance exchange that concerned him when he wrote the bill, but what he saw as a federal encroachment on state rights.

Schaaf said he isn't planning to file any bills that would allow state agencies to work with a federal health exchange.

Supervising editor is Scott Swafford.