HHS Proposes a ‘Second Chance’ for State Exchanges

Published October 4, 2011

With an increasing number of state legislatures and officials declining to create the health exchanges mandated by President Obama’s law, the Obama administration has presented a partnership proposal in an attempt to make them reconsider.

Marguerite Salazar, a regional director of the U.S. Department of Health and Human Services (HHS), announced the potential partnership to Montana legislators, as a “second chance” for the state and other states that have been actively opposing the implementation of an exchange.

According to Rep. Tom Berry (R-Roundup), the partnership appears to be a political tactic rather than a policy reconsideration, as HHS could not provide Montana legislators any definition of the arrangement.

“We were all kind of mystified because we never heard of a partnership with the federal government before. When we asked, ‘What is it?’ they couldn’t answer,” Berry said.

Partnership Without Legislative Approval

Berry is the chair of the interim committee of Montana legislators discussing the implications of implementing a health exchange. Salazar presented the proposal at a recent committee meeting.

Berry stated the overall impression of the meeting was that the federal government would be “working with the state.”

However, the federal government may disagree. Salazar could not define the partnership, including what authority states would have in the collaboration, but she did explain a “partnership” could exist with or without the approval of the state legislature.

“I would be adamantly opposed to that,” Berry said. “The commissioner doesn’t have the authority and shouldn’t be able to create something without legislative approval.”

Berry noted Minnesota Gov. Mark Dayton (D) has been criticized by Republican legislators in the state for unilaterally pursuing the creation of an exchange without legislative approval.

Façade of Cooperation

Because of the overall vague presentation, legislators are left asking why the Obama administration is now offering the partnerships.

Berry said he is unsure, and Salazar declined to comment. The potential partnership may be just another avenue for the federal government to force states into exchanges, under the façade of cooperation, says Christie Herrera, head of the health care task force at the American Legislative Exchange Council (ALEC).

“This proposal is just another way to end-run the legislative process and conscript states into carrying out a major tenet of the federal health reform law. When dealing with exchanges, Secretary Sebelius needs the states more than they need her,” Herrera said. “The federal government hasn’t even appropriated money to establish federal exchanges, and so HHS is counting on the states to spend their time and money on implementation.”

Further Meetings Scheduled

Berry noted he and Montana House Majority Leader Rep. Tom McGillivray (R-Billings) are speaking out against the exchange approach.

“Now that 39 states including Montana have balked at setting up health insurance exchanges, Obama’s administration wants to partner with leftist state insurance commissioners to implement them. We need to refuse this so-called second chance just as we did the first,” McGillivray said at a recent press conference.

Montana’s state agency and several others have been invited to Washington D.C. to discuss the partnership further, at which time additional details may be made available. Berry says the meeting is supposed to take place in October.