Over the past few years, the subject of health care reform has driven quite a wedge into American politics. More than half the states are suing to block the implementation of the individual mandate that will require all Americans to have health insurance starting in 2014. The Republican contenders vying for the presidential nomination next year mention the ACA (generally not in a positive light) in nearly every speech. And yet, some provisions of the ACA are quite popular with voters (things like guaranteed issue coverage starting in 2014 and the provision to allow children to remain on their parents’ policies until age 26, for example). There’s no real consensus about whether we should scrap the law and start over, leave it as it is, or try to change parts of it and leave other parts intact.
Here in Colorado, we’ve had lots of controversy over the law and how the state will go about implementing it. We did manage to get a health insurance exchange board created this summer, and they’ve been working to begin the process of setting up the exchange to have it ready to go in 2014. But the same Representative who co-sponsored the bill to establish the basics for the state health insurance exchange also co-sponsored a bill to allow Colorado to opt out of federal health care reform. It was quite the contentious legislative session.
Last month, some Colorado lawmakers criticized the restrictions and guidelines that HHS laid out regarding the creation of the health insurance exchanges, saying that they basically wanted Colorado to be allowed to design its own health insurance exchange without having to follow rules handed down from the federal government.
That issue again appears to be a sticking point, with Colorado House Republicans blocking the health insurance exchange board from applying for a $22 million grant because the application mentioned changing Colorado regulations to “conform to federal requirements”. The grant application is due at HHS on Friday, and the exchange board will not be able to meet that deadline. They are hoping, however, to address the legislator’s concerns and be able to get the application submitted by the end of the year, to be considered in the second round of funding. The board needs the money from the grant in order to establish the technology framework for the online exchange – obviously an important part of the overall process.
The board has more than two years before the health insurance exchange has to be up and running, and there’s no way to tell whether a few months delay in getting this grant application submitted will have any effect on the overall project. There’s also no way to tell whether the legislators who blocked the grant did so out of genuine concern about the wording of the application, or out of a desire to simply stall the exchange creation process as much as possible. Maybe time will tell.