NASHVILLE (AP) — Republican Gov. Bill Haslam said Monday that a lack of information from the White House is delaying a decision about whether the state should run its own health insurance exchange under the new federal health care law.
Haslam told reporters that President Barack Obama’s administration has refused to address a series of questions about the health insurance marketplaces raised by Republican governors, including whether states would be able to create wellness-based incentives to encourage healthy behavior.
“I think that’s a key to healthcare in the country, people taking more responsibility,” he said.
Other unresolved questions include whether family members participating in different plans will be covered by the same provider; how the state will be able to avoid being double-charged when seniors transition to Medicare; and if the state will be able to access information stored in the federal database.
“You literally have us saying we want to come sit down and talk about this to ask some of our questions, and get answers,” Haslam said. “And their response coming back has been ‘there’s no need in doing that.’ And I don’t find that an appropriate response.”
The governor acknowledged that compliance with the federal health care law is an emotional issue for Republicans who had hoped either legal or political challenges would derail the plan before it went into effect.
“Unfortunately, the Supreme Court ruled, the election happened, and we have to be prepared,” Haslam said.
States have until Dec. 14 to decide if they or the federal government will run their exchanges. As of last late week, 23 states plus Washington, D.C., were proceeding with their own plans; 15 said they’d defer to the federal government to run their markets; and 12 were still mulling over their options.
Starting Jan. 1, 2014, individuals, families and small businesses will be able to buy private coverage through an exchange in their state, with most consumers getting government assistance to pay premiums. The exchanges will also help steer low-income, uninsured people into expanded Medicaid programs in many states.
Haslam’s complaints echo those by other Republican governors including Bobby Jindal of Louisiana and Bob McDonnell of Virginia, who have argued that the Obama administration should release major regulations bottled up for months before they have to make up their minds about a state-run exchange. Some of their main concerns include whether there would be hidden costs of operating the exchanges and the sheer bureaucratic complexity of the new system.
“The White House has basically ignored that and said no, whether it be a personal request through the secretary of (health), a letter to the president, any number of ways we’ve said, ‘We have some questions, we have some things that need to be answered,’” Haslam said. “And they haven’t answered that.”
Health and Human Services Secretary Kathleen Sebelius said in last week’s letter extending the deadline for the state exchange decision that a letter of intent to create state exchange would help her agency assist with finalizing those plans. She said “additional guidance” would be released soon.
“Our team will do everything possible to answer questions and provide technical assistance to state leaders,” she wrote.
Haslam spokesman David Smith said Haslam was invited Monday afternoon to participate in a conference call with Sebelius on Tuesday.
The Obama administration has maintained it will not postpone the Jan. 1, 2014, launch date for the law’s coverage expansion, and it will go ahead in all 50 states. Open enrollment will begin even sooner, Oct. 1, 2013.