Branstad: Not Enough Info For Iowa Exchange Choice

CEDAR RAPIDS, Iowa (AP) - Gov. Terry Branstad plans to tell the federal government Friday that Iowa still doesn't have enough information to move forward with a state-based insurance marketplace under President Barack Obama's health care law, a spokesman said Wednesday.

The federal government has imposed a Friday deadline for states to confirm whether they will create their own health exchanges for consumers and small businesses. States don't have to provide specific details about their plan until next month, but those that don't declare their intention by the deadline will have to move forward with a state-federal partnership or a federal takeover — at least for now.

Branstad spokesman Tim Albrecht said the governor will notify U.S. Health and Human Services Secretary Kathleen Sebelius that Iowa isn't able to decide. Albrecht said the federal government has set arbitrary deadlines for the states without answering basic questions that would help Iowa officials choose the best option.

"We are unable to inform Secretary Sebelius of our intention on a state-based exchange without first having the knowledge on what is required for a partnership exchange with other states," Albrecht said. "We'll convey this in our letter to the secretary on Friday."

The new insurance system is designed to create a marketplace where consumers and small businesses can make side-by-side comparisons when buying health insurance. Supporters of the law say that transparency will ultimately push costs down, while many Republicans have criticized it as an undue intrusion into the private marketplace.

Last week, the U.S. Department of Health and Human Services granted states another month to submit detailed blueprints if they choose to create a state-based exchange. The new, Dec. 14 deadline gives the federal government about two weeks to review all of the proposals, which have to be approved by Jan. 1.

States that choose a federal-state partnership have until Feb. 15 to submit their plans. In a partnership, the states will take charge of consumer assistance and managing the plans, while the federal government provides the information technology needed to run the marketplace.

Albrecht said Branstad has brought together agency administrators and the private sector to discuss what an exchange would look like. Agency officials requested specifics from the federal government about the requirements for each exchange option but have not received enough information, he said.

"We believe we can still move forward with it, and we didn't miss the deadline," Albrecht said. "We are going to let her know that our intent is to pursue this further, once she gives us the information. That's what's been so frustrating. They say, 'We want you to find a solution to this equation, but then leave out a whole bunch of information for us to get it done.'"

The U.S. Department of Health and Human Services is providing the states with "significant flexibility" as they decide how to proceed, agency spokesman Fabien Levy said. Levy said the federal government is willing to work with states that want to run their own exchanges, even if they miss the Friday deadline and aren't able to do so right away.

Albrecht said Iowa officials have talked with other states about joining forces to share the cost of an exchange as a money-saving measure. He declined to name any of the states, saying the talks were informal and nothing has been decided, but described their populations and insurance-delivery systems as similar to Iowa's.

Meanwhile, a key Democratic lawmaker said Iowa has missed its chance to create a purely state-based health exchange, and will likely have to settle for one managed by both the state and federal government.

Sen. Jack Hatch, a Des Moines Democrat, said Branstad has failed to meet key federal requirements to proceed with a state exchange — specifically, setting up a governing body to oversee it. Hatch said Iowa should now apply for a "partnership exchange" between the state and federal government to give the state some measure of control.

"The only two options available to us now are the partnership with the federal government, or defaulting to a federal exchange," Hatch said. "I think it's a failure of the Branstad administration for letting this opportunity be missed. He didn't put together the necessary requirements with the Legislature last year to create a state-based exchange. It's his fault that we haven't been able to get that done."

Hatch said the governor has "boxed Iowa in" with his hope that either the U.S. Supreme Court would declare the law unconstitutional or that Republican Mitt Romney win the presidency and work to repeal it.

He said Branstad's claim that Iowa officials lacked information was an excuse, because other states have already moved forward. Seventeen states and the District of Columbia have taken steps to set up online marketplaces, while 10 have decided not to do so.

"We had significant opportunities to open up discussions with the governor and his people, and he refused," Hatch said. "He's putting Iowa at risk of losing a robust, effective, and affordable exchange, because he put his political agenda first."

Albrecht said moving forward would have been irresponsible, given the uncertainty of the presidential election and the lack of specific guidance from the U.S. Department of Health and Human Services.

"Gov. Branstad has taken a thoughtful approach to Obamacare, but he won't abandon the taxpayers of Iowa by implementing an inefficient and unworkable health care program," he said.
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