Republican Gov. Scott Walker has decided Wisconsin won’t proceed with forming its own state-run health-insurance exchange, but will allow the federal government to implement an exchange in the state instead.
Under President Obama’s law, each state has to set up its own exchange (essentially an online marketplace for health insurance), rely on an exchange designed at the federal level, or form a partnership in which the state performs some functions on behalf of the federal government.
“Instinctively on any issue, I, like probably most governors across the country, Republicans and Democrats alike, given a choice would prefer state-run over anything [run by] the federal government,” Walker said in a press conference announcing the decision.
Walker released his decision on November 16, the deadline date for states to tell the federal government what kind of exchange they intended to pursue, although the deadline was extended by the U.S. Department of Health and Human Services for another month. The governor said he decided the federal government would be so strict with guidelines overseeing state exchanges that states would have little flexibility in determining the specifics.
“It’s like saying you’re going to get a house, the federal government’s going to design the interior, all the amenities, the furniture, everything else, and the only thing left is they ask you if you want blinds or curtains,” Walker said. “And you’re cosigning the mortgage. So you really don’t have a decision about what’s going on, but you are putting your taxpayers at risk.”
Walker’s Allies Wanted Exchange
Walker said he opted for the federal exchange because he believes it’s less risky for Wisconsin taxpayers. Among those pressuring Walker to set up a state-run exchange were some of his closest allies, including Wisconsin Manufacturers & Commerce.
“While WMC supported the creation of a Wisconsin-specific exchange, we acknowledge that Governor Walker makes a good case for not doing so.… WMC will continue to work with the governor and all other state and federal stakeholders to provide as detailed and timely information about the ACA to Wisconsin’s business community as possible,” WMC president/chief executive officer Kurt Bauer said in a statement.
Democrats accused the governor of either punting on the issue or being too extreme.
“Ceding our local control on health-care exchanges not only puts Wisconsin on the extreme fringe, it puts politics above health care for Wisconsin citizens,” said Assembly Minority Leader Peter Barca, D-Kenosha.
But Assembly Speaker-elect Robin Vos, R-Rochester, supported Walker’s decision.
“By not creating a state health insurance exchange, we’re protecting Wisconsin taxpayers from what could ultimately become a major financial catastrophe,” Vos said.
Walker said he had not yet decided about the other major decision facing states—whether to expand the state’s Medicaid program.
Kirsten Adshead ([email protected]) writes for Wisconsin Reporter.