Gov. Jay Nixon acknowledged Thursday that Missouri will not be able to set up an online marketplace for residents to shop for health insurance as envisioned under President Barack Obama's health care. That means federal officials will take over the task — at least for the near future.
Under the federal health care law, states face a Nov. 16 deadline to submit blueprints to the federal government if they want to run their own health insurance exchanges when the online shopping sites are due to open in 2014. If states don't set up their own sites, the federal government will run one for them.
Nixon said he would prefer Missouri run its own insurance exchange. But that's not possible, at least not at this point. Voters on Tuesday passed a ballot measure barring the governor from taking steps to establish a state-run insurance exchange without legislative approval. The Legislature has not granted its approval. And it's not scheduled to be in session until January, meaning lawmakers could not meet the Nov. 16 deadline even if they wanted to do so.
"The only option for Missouri at this time is to indicate that we will be unable to proceed with a state-based exchange absent a change in circumstances," Nixon said at his first news conference since winning re-election Tuesday. But he added: "Let me be clear that a federally facilitated exchange is not the ideal approach. Regulating the insurance market is a power best left in the hands of the states."
So far, 13 states have told the U.S. Department of Health and Human Services that they want to run their own health insurance exchanges. The sites are intended to provide individuals and small businesses a way to shop online for insurance policies, similar to what already exists for airline tickets or hotels. The online marketplaces are a key part of the law's goal of making health insurance more accessible.
Although states must act soon to get federal approval to run their own insurance exchanges in 2014, they are not prevented from deciding in the future that they would like to take over the duties from the federal government. States also have the option of working jointly with the federal government to operate an insurance exchange.
"Most states will take an active role operating their exchange, and we will work with any state to set up an exchange at any time," said Fabien Levy, a spokesman for the U.S. Department of Health and Human Services.
Newly nominated Senate President Pro Tem Tom Dempsey said Thursday that majority party Republicans plan to discuss whether to implement a state-run insurance exchange — as well as other parts of Obama's health care law — during a private agenda-setting meeting next week.