Clay Middleton–June 22, 2011
The Patient Protection and Affordable Care Act passed last year by Congress requires all states to set up a health insurance exchange program. While South Carolina is one of 26 states to sue the federal government over this law, it does not prevent these states from working toward such an insurance exchange program. All states are required to have a health insurance exchange program by the end of 2012. If states fail to do this, the federal government will control their exchange programs.
I’m certain no state would want the federal government to have control over its insurance exchange program no more than the federal government would prefer to. Nevertheless, states have a responsibility to do their part to ensure that a fair, adequate, and open exchange exists. An insurance exchange program would allow people to purchase health insurance policies once it becomes required for everyone to have healthcare coverage in 2014. Individuals would be able to compare healthcare benefits and prices online, through a hotline, or in person by the organization that administers it.
If South Carolina decides to run its own exchange, the state Health Planning Committee, established by Gov. Nikki Haley, would appoint directors who could determine which kinds of policies would be offered, decide who is eligible, oversee federal subsidies, and perform other assigned tasks related to the Patient Protection and Affordable Care Act.
The health insurance exchanges must be able to operate without federal funding by 2015. The state has received a $1 million grant to set up this exchange, but the state Department of Health and Human Services does not want to apply for additional federal funding when the next application is due at the end of June.
Why would South Carolina not seek the federal funds it can access in order to implement parts of the Patient Protection and Affordable Care Act? I forgot, S.C. Republicans prefer to let the state suffer and blame Democrats and the administration for the lack of support, the failure of Medicaid, and rising healthcare costs. The state believes that local tax dollars and funding from private industry will be enough to support the new exchange program.
Would it not be in the best interest of the state to meet the requirements of the law, work with the U.S. Department of Health and Human Services, and ensure all deadlines are met to secure federal dollars rather than have those dollars go elsewhere? It’s simply not smart for South Carolina to give back money to the federal government because the state was unable to meet deadlines and failed to apply for additional federal funds. Furthermore, to privately fund this process by fees on consumers or employers or from health insurers interested in exploring new industry models, as the S.C. Department of Health and Human Services Director Tony Keck has stated, does not make sense if you want this exchange to work well into the future.
The S.C. Health Planning Committee must move quickly to meet the self-imposed deadlines for gathering demographic data, assessing online capabilities, and planning the application process. If such deadlines are not met, there will be no money for us.
Politics aside, the fact remains that having an exchange program will allow for competition, affordable rates, and better healthcare coverage. The argument disputing that comes from people with health insurance who have never had to use it. This planning committee must be held accountable in making sure that it accomplishes its mission.
For us in the Lowcountry, we may not be able to speak to all 11 members of the committee to offer advice and put a face on the situation, but we can reach out and talk to two area members on the Health Planning Committee, Rep. David Mack and Dr. Casey Fitts. Knowing both gentlemen, they will look out for the state’s best interest. Our concern should be with the seven people Haley has influence over.
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