From The New York Times
The Obama administration said Friday that more than half the states had rejected
its pleas to set up their own health
exchanges, dealing a setback to President Obama’s hopes that
Republicans would join a White House campaign to provide health insurance to all
Friday was the deadline for states to notify the
federal government of their plans, and administration officials had been hoping
that Mr. Obama’s re-election would overcome resistance to the new health
Federal officials said they knew of 17 states that
intended to run their own exchanges, as Congress intended.
The exchanges are online supermarkets where people can
shop for private health insurance and obtain federal subsidies to help defray
the cost. The Congressional Budget Office
has estimated that 25
million people will eventually receive coverage through the exchanges.
Federal officials and federal contractors will set up
and run the exchange in any state that is unable or unwilling to do so.
The concept of an exchange is simple: Competition will
drive down prices. But operating an exchange is an immense technical challenge
requiring sophisticated information technology to digest and display huge
amounts of data on the costs and benefits of various insurance plans.
Administration officials said they were delighted this
week when a Republican governor, C. L. Otter of Idaho, announced plans to
establish a state-run exchange.
However, Mr. Otter’s rationale provided little comfort
to the administration. He said he did not want to surrender power to “federal
bureaucrats.” He denounced “the mandates and overreaching federal authority of
the Affordable Care Act
said the law “will do little or nothing to reduce costs while force-feeding us
coverage and increasing the size and scope of government.” And he said his
decision could be rescinded if the State Legislature disagreed with him.
Pennsylvania seriously considered running its own
exchange, but Gov. Tom Corbett said on Wednesday that he would not pursue the
“State authority to run a health insurance exchange is
illusory,” Mr. Corbett said. “In reality, Pennsylvania would end up shouldering
all of the costs by 2015, but have no authority to govern the program.”