States around the country have spent the last few months working hard to set up Health Insurance Exchanges – competitive health insurance marketplaces that help people compare and enroll in quality health insurance. However, over at the U.S. House of Representatives, things look a little different. As part of the House Leadership’s continued attempts to “repeal, replace, defund” the Affordable Care Act, House Members will vote on H.R. 1213 today, which would repeal any funding to help states create the Exchange marketplace over the next three years.
Exchanges are one of the cornerstones of the ACA. They are an accessible, consumer-friendly portal for individuals and small businesses to compare health plan options and choose the best plan for them. The Exchanges will make it easier for people who have been uninsured, had difficulty affording insurance, or had trouble paying for coverage for their employees, to get and keep health insurance. It will also make it easier for people to know what is in the health plan they purchase because there will be standards for what insurance plans need to provide to participate in the Exchange.
In a time of record state budget deficits, state governments need financial help to build an infrastructure to support the Exchange – all but one state (Alaska) have already received federal dollars and have to plan for their Exchanges.
Without funding assistance from the federal government, states have two choices: spend their own money to establish an Exchange or stop the work they’ve already begun and waste money already spent. Both options are untenable. Things like updating IT systems, creating seamless enrollment through the Exchange, and providing information to consumers and small businesses about the changes to the insurance market are considerable investments.
The official budget estimate of H.R. 1213 says states that continue the work with their own funds are likely to charge insurers more to make up their costs – and the insurers will pass along the cost to consumers as higher premiums. Fewer people will get subsidized coverage as states struggle to get their Exchanges up and running. In fact, most of the savings from the bill come from less federal spending on subsidies, not from the elimination of the state planning grants.
States get that Exchanges will create an important marketplace for small businesses and consumers to find health insurance. Even in states with political leadership that is not wholly supportive of the ACA, policymakers have continued to pursue the creation of Exchanges and use federal funds to move the planning process forward. Exchange planning has also brought together and been supported by diverse stakeholders like providers, insurers, consumer advocates and business. (To find out what helps to build a consumer-friendly Exchange, check our Top Ten.) Apparently, Congress isn’t paying attention to these efforts to move forward.
Today’s vote in the House to repeal funds to help states to set up Exchanges will mean a return to a health care market that is less transparent, less consumer friendly, more costly and more difficult to navigate. It means people will continue to fall through the cracks. Americans don’t want to go backwards to a broken health care system. They don’t want Congress to take away from them the health security Members enjoy themselves. They want to move forward.
Here are some actions you can take on H.R. 1213 and Exchanges:
- — If your Representative votes for H.R. 1213, call and tell them their vote is bad for consumers and bad for the state. Let them know that you want your health care system to move forward, not backward.
- — Write a blog about the importance of the Exchange and what’s happening in your state. Let your supporters know if your state is moving forward on an Exchange and the important role for consumers to play in its development.
- — Talk to media about the vote. Explain the importance of an Exchange, your state’s progress in creating an Exchange, and how the Exchange will help consumers in your state.
— Christine Barber, Senior Policy Analyst and Reena Singh, Field Coordinator