Thought the deadline for states to determine which exchange model they would be using has already passed? Surprise - there is one more! Today, February 15, is the last day for states to decide whether or not they will enter into a partnership exchange with the federal government. While most states have gradually been making their decisions, a few key states have been building suspense and holding out. Several states have expressed concerns regarding the exchange models, saying that the Administration has not provided them with enough information to make a final decision. Well, Virginia, Utah, Florida and New Jersey, your time is up. The governors of these states are all long-time PPACA opponents and they have generally been loath to comply with any of its conditions. While the exchange decisions they make today will have implications for years to come, the initial decision the states make could be changed eventually. For example, if a state decides to default to a federally facilitated exchange, in three years, once reform has been further implemented and everyone has a better idea of what the exchanges will actually look like, a state may then leave the federal exchange and implement its own state-based exchange.
In Virginia, Republican Governor McDonnell has already vetoed the idea of a state-based exchange and claims that he has rejected the idea of a partnership, which only leaves defaulting to the federal exchange. However, McDonnell has stated that he would approve legislation that leaves the state of Virginia in control of plan management within the exchange (not that something like that is going to pass today, but you never know).
As for Utah, Governor Gary Herbert is in a similar position. As a longtime opponent of PPACA, Herbert has opposed the idea of a state-based exchange, but has put forth a proposal that leaves the state in control of some aspects of the insurance market. Namely, he wants the state to maintain control of the exchange already in place for the states small businesses, leaving the rest to the federal government. Herbert has said that he does not want a partnership exchange, but with such heavy state involvement it looks like Utah may end up partnering with the federal government, regardless if that is what they want to call it.
In Florida, Governor Rick Scott, who once led the fight against PPACA at the Supreme Court, has been going back and forth and has yet to make an official exchange decision. Recent reports, however, have hinted that Florida, after going back and forth for many months, will end up in a partnership exchange with the federal government.
In New Jersey, Governor Chris Christie may have befriended President Obama in the wake of Hurricane Sandy just before the election, but he has been a vocal opponent of PPACA and has vetoed Democratic proposals pushing a state-based exchange model. While he has been keeping relatively quiet (for him), Christie has not completely ruled out the idea of entering into a partnership exchange. Which way will he go? We will find out soon enough!
Once the states make their official decisions the next big PPACA deadline is on October 1 when open enrollment is set to begin. We can hardly wait!