Federal health insurance exchange for SC

Tea Party saber rattling is making S.C. House Republicans jump ship on supporting legislation (H.3738) creating a health insurance exchange in our state. The Tea Party calls in “Obamacare” because an exchange in each state is part of the Affordable Care Act (ACA).

The ideal exchange would be an online, transparent, competitive, consumer-friendly marketplace where individuals and employees of small businesses can shop for high-value health insurance and receive premium subsidies starting in 2014.

The ACA requires the state to set up the exchange or the federal government will do it for the state. A viable exchange was also one of the requirements the Obama administration laid down for a state to have in order to be even considered for opting out of the ACA requirements.

So if the Tea Party wants South Carolina out from under the ACA, why are they making House Republicans withdraw support for a legislative vehicle to create a state exchange that must pass the House this year in order for there to be any chance of the Senate passing some amended version of it next year? (More on this later.)

The answer can be found in an e-mail sent to Tea Party faithful in the last few days by Talbert Black, Interim State Coordinator of the Campaign for Liberty.

Our legislators have been deceived into thinking that we must have H3738 in place to avoid the federal government setting up the exchange for SC but this is NOT true, the guidelines for setting up an exchange are so arbitrary that if it is necessary we have years to do so, it does not need to be and should NOT be implemented now.

In the spirit of full disclosure, Talbert has been on my radio show several times. I like him (except for the awful, bright orange shirts he customarily wears) and he is passionate about Tea Party issues, some I even agree with. Unfortunately, Talbert has been given some very bad advice.

The ACA is very specific about the January 1, 2014 deadline for an exchange, either state or federal, to be in operation. But the timeline needed to have an exchange fully operational by 2014 starts well before that. This will be a very complicated, slow process. It will take a year at least to get done. Come January of 2013 if South Carolina is not well on its way in creating an exchange, it and all the other state’s like it will be included in a federal exchange.

So that means that the Legislature (or Governor Haley if she thinks she can set up an exchange within the Department of Insurance without legislation) will need to act in 2012. But the Legislature adjourns in June so all it has is the last two months of this year’s shortened session and the first 5 months of next year. Experienced strategists very familiar with our political and legislative process believe that there is almost no chance that we can wait until next year to move controversial legislation out of the House Ways and Means Committee, the full House, Senate Finance Subcommittee, Senate Finance and the full Senate by June of 2012.

We don’t have “years” to set up an exchange. We have months.

Proponents of H.3738 have already agreed to amend the bill to delete certain contentious sections that can be filled in next year after the Governor’s Exchange Planning Committee completes its work. But at least the legislative vehicle can move forward giving the General Assembly the chance to create the exchange.

Otherwise, Governor Haley can try to do it on her own and take the political Tea Party heat (and most likely a court challenge).

Say hello to a federal health insurance exchange for South Carolina. That’s where we’re heading. We actually might be better off.