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By JEFF AMY
JACKSON â Mississippiâs insurance commissioner is going ahead with a state health insurance exchange, over objections from Gov. Phil Bryant, a fellow Republican.
Commissioner Mike Chaney sent a letter Wednesday to the U.S. Department of Health and Human Services saying Mississippi will run its own exchange. He said the state will submit the full plan by today. Federal officials must approve the plan, but Chaney says heâs confident Mississippi will ultimately get the go-ahead.
âItâs done,â Chaney told the health insurance exchange advisory board, which has helped design the online insurance marketplace, at a meeting Wednesday.
Chaney has worked toward building an exchange despite pressure from Bryant and others to abandon participation in the federally subsidized marketplace.
âThe whole goal here is to help the consumer in this state have more information and make an intelligent decision about what they are going to buy,â the commissioner said.
Chaney said he and Bryant discussed the submission in a Tuesday meeting, but Bryant said Wednesday he is still opposed.
âI have, again, been against the expansion of Obamacare throughout the state of Mississippi. I believe a health care exchange is a portal for that,â Bryant said in response to reporters at the state Capitol. âIâm worried about the federal government taking over that system, and I worry about expanding a large entitlement program in the state of Mississippi through what was to be a free-market based system in the insurance exchange. So, Iâm disappointed.â
Bryant and other state leaders also have also opposed Mississippiâs participation in an expansion of the federal-state Medicaid program to cover hundreds of thousands more poor people, saying the state government canât afford its share of the future costs. That expansion is optional, though, and separate from the insurance exchanges.
States face a deadline today to say they would run their exchange. The federal government extended the deadline for submitting the plan until Dec. 14. Without action, the federal government would set up exchanges for each state.
Chaney said heâs no fan of the new federal health care law, but says Mississippi would be better off controlling its own exchange.
âIf you default to the federal government, you forever give the keys to the stateâs health insurance market to the federal government,â he said.
State regulation means Mississippi can set the minimum coverage requirements, regulate policies and make sure claims are paid promptly, Chaney said. The state plans to operate an exchange where policies wonât be subsidized alongside the subsidized market mandated by the health care law.
Bryant said he believes the federal government will essentially control the exchange.
âAt some point the federal government is going to require you to maintain the guidelines they established,â Bryant said. âI do not believe that since the federal government has put over $20 million into this exchange that theyâre going to say, âItâs yours, Mississippi, and you can manage it.â Certainly, theyâre going to take it over.â
Opponents say the state wonât have enough freedom and Mississippi should have no association with a law they find odious.
âTheyâre showing us there are lots of free market ideas that supposedly the exchange will give us, but theyâre in direct conflict with the socialist ideas being put out by the Obama administration,â said Laura VanOverschelde of the Central Mississippi Tea Party.
At times, tea party opponents appeared in force at advisory board sessions to protest, but Chaney wasnât swayed.
âI donât like it; I would not vote for it; I think it needs to be repealed. But it is the law,â Chaney said.
Former Republican Gov. Haley Barbour, unlike Bryant, favored the concept of an exchange. State legislation to establish an exchange failed, but Chaney said he had legal authority to go ahead even without the law.
Chaney said that only an act of the Legislature could derail the process now, but since federal money is being used to launch the exchange, he predicted lawmakers wouldnât interfere.
One advisory board member, Therese Hanna, said Chaneyâs determination was validated after President Barack Obamaâs re-election.
Hanna, who is executive director of the Center for Mississippi Health Policy, said it was still unclear if the market will flourish, but she said an exchange tailored to Mississippi conditions could provide a better home for the hundreds of thousands of state residents. who are supposed to get federal money to help them buy policies.
The state Insurance Department has received more than $20 million in federal money to develop the exchange. The marketplace will be operated by the Mississippi Comprehensive Health Insurance Risk Pool, which will contract with outside groups for most services. The risk pool group was established in 1992 to help people with pre-existing conditions find health coverage.
Chaney said one advantage of state regulation is that more insurers were likely to offer policies.
United Health Group already offers two policies on the Mississippi exchange. Chaney said more insurers would begin offering policies starting in about six months, assuming federal approval, growing to as many as 10 insurers.