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Health & Science

Advocates and Others Await Walker Decision on Health Care Exchange

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Although the U.S. Supreme Court upheld it this year, the fate of the president’s health care overhaul was uncertain until the election. Governors, such as Wisconsin’s Scott Walker, put off implementing portions of the Affordable Care Act until after the vote, hoping the law would fall, if the president did. However, despite Obama’s victory last week, Gov. Walker has not yet made public his plans for meeting a key demand of the law. As WUWM’s Ann-Elise Henzl reports, interested parties are waiting, as a deadline approaches.

States have until Friday Nov. 16 to announce whether they’ll implement a health insurance exchange. For those that don’t, the federal government will impose one. Under the Affordable Care Act, the exchanges create what the Obama administration calls a “marketplace” of insurance companies. Customers will be able to shop for health coverage by reviewing cost and quality.

According to the White House, two-thirds of the states are “on their way to building exchanges.” After election results came in Tuesday, Wisconsin’s governor remained vague about this state’s plans, saying: “We’re going to go forward in a way that ultimately looks out for the best interests of the people of the state, both as consumers but also as taxpayers.”

Days later, Scott Walker’s decision remained a mystery. He and his health secretary declined interviews. The governor’s spokesman would only say Walker would “be meeting with key members of his administration over the next several days to decide the next steps.”

With the deadline looming, supporters of the legislation are eager for action. Milwaukee Democratic Rep. Jon Richards and 17 other lawmakers sent the governor a letter late last week. It urged Walker to immediately create a bipartisan group to implement the Affordable Care Act. Richards says a bipartisan group was making progress on the health care exchange aspect until Walker took office, and applied the brakes.

“We’ve been asking them to create an exchange that’s right for Wisconsin for almost two years now. We’ve been asking them to put their political posturing aside and start getting to work for health care consumers in Wisconsin to create an exchange that makes sense for Wisconsin,” Richards says.

What would make sense, Richards says, is a state-run exchange reflecting Wisconsin’s health care marketplace. He says if the state fails to act, the federal version might be one size fits all – for instance, with just a couple of insurance plans available. The Democrats’ letter hints the governor may be working on the issue behind the scenes, not disclosing anything to the public and not seeking input from stakeholders.

Robert Kraig’s accusation is more pointed. He’s with the advocacy group Wisconsin Citizen Action. It obtained documents through an open records request. Kraig says they indicate the governor may move forward with an exchange that includes insurance plans that don’t meet standards.

“We think there are probably eight other states or so that are similarly, bitterly opposed to the Affordable Care Act and might try to essentially put forward substandard exchanges and try to play a game of chicken with the federal government, in hopes that they can be allowed to move forward,” Kraig says.

Another observer does not perceive a sinister plan taking shape, although he’s eager to know what’s going on. Eric Borgerding is executive vice president of the Wisconsin Hospital Association. He says the group favors a state-run exchange, and wants medical professionals included on the board that would provide oversight.

“We think that it’s important that health care providers, certainly hospitals or health systems, have representation on that board. It’s kind of difficult to imagine a system that would be run without some sort of input from the provider community,” Borgerding says.

Even an adamant opponent of the president’s health care overhaul is eager for movement on a Wisconsin exchange. Bill G. Smith is state director for the National Federation of Independent Business. It challenged the Affordable Care Act in court. Smith says health care is the number one problem small businesses face, and if an exchange can bring down costs for patients and employers, that would be a good thing.

“There’s really nothing inherently wrong with an exchange -- if it is administered properly, if it’s driven by private sector principles, if it promotes more competition and choice in the private insurance market, if it’s transparent,” Smith says.

Smith notes that the concept of a health care exchange is not partisan, or new. He says years ago – before either President Obama or Gov. Walker held their posts -- Smith’s pro-business group worked with lawmakers in an attempt to create a health insurance purchasing pool.

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