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Health Insurance Exchanges under the Patient Protection and Affordable Care Act in Georgia

Georgia Governor Nathan Deal has announced that the state will not establish a health insurance exchange pursuant to the provisions of the Patient Protection and Affordable Care Act (PPACA). The Act requires all states to have a health insurance exchange where individuals and small groups who did not have the means to acquire health insurance coverage in the past will be able to have coverage at affordable costs. The governor cited the many unknown costs associated with setting up a state-run exchange, the lack of flexibility, and the lack of control by the state in his decision to opt out of the exchange. The law allows three options for running the exchange where states can either set it up, partner with the federal government, or leave it to the federal government to operate. A Supreme Court ruling states that the federal government cannot compel state governments to run exchanges nor expand Medicaid as the PPACA is attempting to do.

Experts believe that even if state governments establish health insurance exchanges, the federal government will still have control over the insurance marketplace. There are those who believe that the exchanges will be competing with private insurance companies and may eventually drive many of these companies out of business. Health insurance exchanges will take the form of virtual marketplaces where people can shop for health plans at affordable costs. People with low income and those with special needs might be eligible to receive premium credits or participate in special programs that will be subsidized by the federal government. Many are concerned by the fact that Congress has not appropriated funding for federal exchanges. If state governments refuse to run their own exchanges, the federal government will run it for them.

Many state officials reject the one-size-fits-all nature of federally run health insurance exchanges saying that they would not want to spend state tax dollars on a program that is run by the federal government. Many support a free market-based route to providing health care that would truly benefit small businesses, which is forbidden by the PPACA. The restrictions on what a state-run health insurance exchange can and cannot do nullifies the idea that the state of Georgia can tailor-fit an exchange to its unique requirements.

Other states have also informed the federal government of their decision not to establish insurance exchanges, including Ohio Governor John Kasich and Wisconsin Governor Scott Walker. As of November 2012, around 14 states have started enacting health insurance exchange laws. The cutoff date for state governments to inform the federal government of whether or not they plan to establish health insurance exchanges is December 2012, at which time the states that plan to create their own exchange should be able to show a blueprint of their exchange.

Those opposed to the PPACA claim that it remains to be unpopular three years after it was passed. A November 2012 survey revealed that 50 percent of the population still wants the law repealed. Another poll suggests that only 38 percent of Americans favored the law.

After U.S. President Barack Obama's re-election, Georgia Governor Nathan Deal was quoted as saying he will not be implementing a state run health insurance exchange. Deal said he will not reveal his decision until officially notifying the federal authorities. But he said that state health authorities ceased planning for an exchange after federal authorities came out with regulations restricting the ability of state governments to design their own programs. The PPACA allows states to establish their own exchanges or default to a federal government-run exchange. Whether people would actually notice difference between a federal or a state operated run exchange remains to be seen. Deal's refusal to support a state-run exchange underlines the political and philosophical issues surrounding the implementation of the Act.

Deal claims he initially wanted to consider a health insurance exchange operated by the state and appointed a committee to study its merits. The panel recommended against a state-run exchange. Deal also said he will wait until after the election to decide on the question of the exchange. Republican candidate Mitt Romney promised to repeal and replace the PPACA, a concept that is rendered moot by President Obama's reelection.

When Deal was asked which policy cannot be implemented in Georgia as part of the exchange, he cited association plans. These plans allow a trade or professional association to create a group insurance pool to spread risk and make coverage more affordable.

Georgia Governor Nathan Deal has announced that the state will not establish a health insurance exchange pursuant to the provisions of the Patient Protection and Affordable Care Act (PPACA). The Act requires all states to have a health insurance exchange where individuals and small groups who did not have the means to acquire health insurance coverage in the past will be able to have coverage at affordable costs. The governor cited the many unknown costs associated with setting up a state-run exchange, the lack of flexibility, and the lack of control by the state in his decision to opt out of the exchange. The law allows three options for running the exchange where states can either set it up, partner with the federal government, or leave it to the federal government to operate. A Supreme Court ruling states that the federal government cannot compel state governments to run exchanges nor expand Medicaid as the PPACA is attempting to do.

Experts believe that even if state governments establish health insurance exchanges, the federal government will still have control over the insurance marketplace. There are those who believe that the exchanges will be competing with private insurance companies and may eventually drive many of these companies out of business. Health insurance exchanges will take the form of virtual marketplaces where people can shop for health plans at affordable costs. People with low income and those with special needs might be eligible to receive premium credits or participate in special programs that will be subsidized by the federal government. Many are concerned by the fact that Congress has not appropriated funding for federal exchanges. If state governments refuse to run their own exchanges, the federal government will run it for them.

Many state officials reject the one-size-fits-all nature of federally run health insurance exchanges saying that they would not want to spend state tax dollars on a program that is run by the federal government. Many support a free market-based route to providing health care that would truly benefit small businesses, which is forbidden by the PPACA. The restrictions on what a state-run health insurance exchange can and cannot do nullifies the idea that the state of Georgia can tailor-fit an exchange to its unique requirements.

Other states have also informed the federal government of their decision not to establish insurance exchanges, including Ohio Governor John Kasich and Wisconsin Governor Scott Walker. As of November 2012, around 14 states have started enacting health insurance exchange laws. The cutoff date for state governments to inform the federal government of whether or not they plan to establish health insurance exchanges is December 2012, at which time the states that plan to create their own exchange should be able to show a blueprint of their exchange.

Those opposed to the PPACA claim that it remains to be unpopular three years after it was passed. A November 2012 survey revealed that 50 percent of the population still wants the law repealed. Another poll suggests that only 38 percent of Americans favored the law.

After U.S. President Barack Obama's re-election, Georgia Governor Nathan Deal was quoted as saying he will not be implementing a state run health insurance exchange. Deal said he will not reveal his decision until officially notifying the federal authorities. But he said that state health authorities ceased planning for an exchange after federal authorities came out with regulations restricting the ability of state governments to design their own programs. The PPACA allows states to establish their own exchanges or default to a federal government-run exchange. Whether people would actually notice difference between a federal or a state operated run exchange remains to be seen. Deal's refusal to support a state-run exchange underlines the political and philosophical issues surrounding the implementation of the Act.

Deal claims he initially wanted to consider a health insurance exchange operated by the state and appointed a committee to study its merits. The panel recommended against a state-run exchange. Deal also said he will wait until after the election to decide on the question of the exchange. Republican candidate Mitt Romney promised to repeal and replace the PPACA, a concept that is rendered moot by President Obama's reelection.

When Deal was asked which policy cannot be implemented in Georgia as part of the exchange, he cited association plans. These plans allow a trade or professional association to create a group insurance pool to spread risk and make coverage more affordable.

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