Health Insurance Exchanges: It’s Time for Decision

Republican governors are facing a difficult decision. They must choose by tomorrow whether or not their states will be in charge of the impending health insurance exchanges. If they choose to take charge of the insurance exchanges, they have until 14 December to provide the details to the federal government. If they choose to turn over responsibility of the exchanges to the federal government, they are submitting to the federal government controlling a portion of the healthcare in their states.

This puts those Republican governors in a tricky position. Is it better to take responsibility for these exchanges, even with the risk of not knowing all the details in advance? Or is it better to turn responsibility to the federal government, where the exchanges would be less customizable to each individual state?

This issue is also complicated by a desire to preserve a political image. Let’s look at Missouri: the state legislature decided that the governor could not make a decision about the health insurance exchanges without the approval of the legislature. However, the legislature doesn’t meet again until January, meaning that there will be no decision by Friday, and thus, Missouri’s insurance exchange will be run by the federal government. I don’t doubt that Missouri’s legislature knew what they were doing, but it seems likely that they were trying, to some extent, to make a political statement.

I submit that it is time for the state governors to evaluate what is best for their state and make a decision based off that evaluation. Now is not the time for political statements. It is the time, regardless of political stance, to take action and move forward with what we must do next. Whether that calls for a state-run or a federally-run exchange is up to each state, but across the nation, it is time for action rather than protest.