Message to feds--ball's in your court

So it’s unofficially official.

South Carolina will have a health insurance exchange run by the federal government starting January 2014. Yesterday, Governor Haley’s administration re-confirmed that our state would not ask the U.S. Department of Health and Human Services (HHS) for additional money to plan for setting up an insurance exchange. That is the path all other states intending to operate their own exchanges are taking.

While the official word on letting the feds do it has not been made, it was very clear at the 3+ hour meeting of Gov. Haley’s SC Health Planning Committee yesterday that there was no interest in even discussing an exchange. The Gov. set up the Committee by Executive Order back in March in response to legislation introduced in the House to create a South Carolina exchange (that bill is stalled in committee). A $1 million federal grant from HHS for the purpose of studying the feasibility of a state exchange is paying for the work of the Committee.

The word “exchange” was ever barely mentioned during yesterday’s meeting and only probably twice in passing. It was clear that the mission of the Committee was not to decide if our state should set up an exchange but to discuss ways of reducing health care costs. Of course this is an excellent topic but hardly what the feds gave us the grant to do.

So what started out as Governor Haley’s insistence that South Carolina would figure out how to get out from under the Affordable Care Act by setting up our own version of an exchange (to meet President Obama’s criteria), now looks like a decision to just let the feds do it. The eventual official announcement will be played down and the rational will be why spend the time and effort with long-term financial responsibility to do something that the feds are willing to do for us for free.

That is a very logical, practical and honorable decision to make—and the right decision for us, especially for the health care consumers.

But it also means that South Carolina is ending its pipedream of setting itself free of the Affordable Care Act, which will not be ruled unconstitutional by the Courts.