[r78] Crouch Capitol Connection: Health Care Exchanges: State vs. Federal (7/14/2011)

In the Health Finance Commission, a summer study committee of which I am a member, we recently discussed the issue of setting up a Health Care Exchange as required by the federal Affordable Care Act (ACT).

A Health Care Exchange is a marketplace that offers purchasers of health insurance, such as individuals, or small employers, a variety of plans from different insurance providers. It would make shopping for insurance similar to shopping for a plane ticket or hotel room on Expedia.

A Health Care Exchange must be implemented by January 1, 2014 according to ACT. Governor Daniels made an executive order this year that the State of Indiana must plan for an exchange. This, however, does not commit the state to an exchange. The state can stop implementation of an exchange if ACT is found unconstitutional or for other reasons.

In the Health Finance Commission this week, we were weighing the option of whether to adopt a state-run or federal-run health care exchange. Currently, the State of Indiana has applied for multiple grants to plan for an exchange, many of which have been approved. This will help us cut down on the cost to taxpayers during this phase.

Here is a brief overview of Hoosiers age 0-64 with insurance coverage:

• 875,000 people uninsured (16 percent of Indiana's population)
• 950,000 people with public programs (17 percent of Indiana's population)
• 200,000 people with individual programs (4 percent of Indiana's population)
• 3,600,000 people with employer-sponsored programs (63 percent of Indiana's population)

In September 2010 a questionnaire was given to businesses and insurers that reside in Indiana. They were asked who they prefer to run a Health Care Exchange. Eighty percent of insurers preferred the state and 20 percent were undecided. For businesses, 55 percent were undecided, 38 percent said the state, and 7 percent said the federal government.

As of yet, a federal exchange model has not been offered.

In conclusion, Indiana is one of the 26 states that has filed against the federal government questioning the constitutionality of ACT. We are now working to responsibly examine the many options available to us, but it will be quite some time until a final decision is made.

If you have any thoughts on Health Care Exchanges and would like to contact me, you may call my office at 317-232-9769 or email me at H78@in.gov. As always, I appreciate your support and welcome your feedback.

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State Rep. Suzanne Crouch (R-Evansville)