By Bobby Harrison/NEMS Daily Journal
JACKSON – Believe it or not, Republicans in the Mississippi Legislature might be more gung-ho to enact a portion of the controversial federal Affordable Care Act than their Democratic colleagues.
The Legislature is considering a proposal to establish a health insurance exchange. The exchange is a key component of the Affordable Care Act passed in 2010 that dramatically increases the number of Americans with health care coverage and puts limitations on insurance companies’ ability to drop coverage. The exchanges have been described as a one-stop shop where people can go to pick out the insurance policy that best suits their needs. In theory, the insurance rates will be cheaper because of the large number of people participating in the exchanges.
States are supposed to have the exchanges up and running by 2014. If the states don’t set up an exchange, then the federal government will step in and do it.
Some Republicans, convinced that the health care law is going to be found unconstitutional, have said there is no need to worry about establishing the exchanges.
But there are some problems with that logic.
First of all, the part of the law that some believe is unconstitutional is the individual mandate that requires most Americans to have health insurance. True, a federal judge in Florida said the whole law is unconstitutional.
Most legal scholars, though, even those opposed to the individual mandate, question the validity of that ruling.
Plus, a lot of people want the exchanges to stay in existence.
Heck, Republican Gov. Haley Barbour was talking about establishing a health care exchange in Mississippi during his re-election campaign in 2007.
At the time, he was focusing on the exchanges as a mechanism for small businesses to use to purchase insurance for their employees.
Under the federal model, the exchanges could be used by small businesses and individuals as a one-stop shop to find health care coverage.
Barbour has stated that he is still interested in establishing an exchange in Mississippi. He has $1.5 million in his budget proposal to do just that.
The request for money in what is a difficult budget year for the state is a bit puzzling since there are federal funds available to pay for most if not all of the cost of setting up the exchange.
Barbour and Republicans have two reasons to want to pass an exchange in the Mississippi Legislature.
First, they want to determine how the exchange will look instead of letting the federal government develop it.
And second, as already stated, Barbour has been an exchange supporter for some time.
If he runs for president, as he is expected to do, he needs to be able to tout some type of health care credentials. Regardless of how people feel about the health care law, most Americans agree that the current system is not working and changes need to be made.
In 2012, they will be looking for presidential candidates who oppose the Affordable Care Act to provide an alternative.
Let’s face it, there is not much in terms of health care that Mississippi and Barbour can tout. We have some good physicians and medical providers, but not enough of them. We are known as the least healthy state in the country.
Most of the news Barbour has made in terms of health care has been for the efforts of his administration to curtail coverage – whether it was the effort to remove 60,000 working poor and elderly from the Medicaid rolls in his first term or to increase the tax on hospitals or to allegedly make it more difficult for some disabled children to receive Medicaid coverage.
Barbour needs something he can point to and say he made an effort to improve health care in Mississippi.
The health care exchange would give him something to tout.
On the other hand, some legislative Democrats may figure that the federal government rather than Barbour and legislative Republicans might fashion an exchange in a way to ensure more Mississippians are covered.
So in this particular case, it might be Republicans more than the Democrats in the Legislature interested in enacting a portion of the controversial health care law.
Bobby Harrison is the Daily Journal’s Capitol Bureau Chief. Contact him at firstname.lastname@example.org or call (601) 353-3119.