The Health Care Reform Review interim legislative committee has just completed its work on a bill concerning a state health insurance exchange which will be considered during the special legislative session beginning Nov. 7. There has been a great deal of work and discussion on whether the state of North Dakota should establish its own exchange or should it let the federal government's exchange take over. (Federal health care reform law requires that there be an exchange which will permit citizens to compare health insurance policies and make educated choices about what coverage to have.)
The legislative committee members agree that North Dakota should establish its own program, so that we have control over it. There are deadlines in the federal law for states to meet regarding planning for the exchange. If those deadlines are not met, not only will the feds end up in control, but the opportunity to use federal funds for the planning of the exchange will have passed. The U.S. Supreme Court is expected to consider the lawsuit concerning federal health care reform in the summer of 2012. If only parts of it are overturned, and not all of it, the state will most likely still be required to have an exchange. It is the law right now. However, if we wait for the court ruling, all of the deadlines for planning and for funding will have passed, and there will absolutely be no way that the state could go back and decide to do its own exchange. If the court overturns the requirement, N.D. can stop the planning process for its own exchange, if desired.
If we let the federal exchange take over, N.D. will have no say in how the exchange would work or how many insurance companies and policies might be available for consumer choices. The state would no longer have complete authority to regulate insurance providers and determine policy standards. Although many of us are concerned about the cost of establishing the state exchange, right now federal funding is available. Legislators know that federal funds are taxpayer dollars, too, but we have more control over that spending with a state-run program. After 2015, the feds will charge the states for running the exchange and we will have no control over what the state will pay or what policies should be available or what eligibility standards we want to have.
If we do nothing, we will still be paying for it, but we will have little or no control over the exchange.
Under the proposed bill, a governing board will be established to set up the exchange, along with two advisory boards to assist with technology and expertise in various areas. Navigators, as required by federal law, will be available to assist citizens in learning about their options, along with insurance brokers and agents. A new computer-based system for determining eligibility for Medicaid and Children's Health Insurance Program (CHIP) will be developed; it is needed whether we proceed with the health insurance exchange or not.
This one small piece of federal health care reform is extensive and expensive and is just the beginning of the changes that the law requires. North Dakota legislators supported the idea of doing what the federal law requires, but not more. Even the minimums require big changes, and we want the state to do its work carefully and correctly in order to meet the federal requirements and to meet the needs of North Dakota citizens.
If you have any questions about this or any other issues, contact any of your District 13 legislators: Senator Judy Lee, firstname.lastname@example.org, 282-6512; Rep. Kim Koppelman, email@example.com, 282-9267; Rep. Alon Wieland, firstname.lastname@example.org, 282-9470; or visit our website at www.district13republicans.com.