Walker wrong to halt work on insurance exchanges
The governor is betting that health care reform will be struck down by the Supreme Court. We think it's a bad bet.
Walker said in December that the state would halt work on the online exchanges until the U.S. Supreme Court rules on the constitutionality of the health care law. The high court is considering a collection of lawsuits challenging the law; a decision is expected this summer.
In a recent interview with the Editorial Board, Walker said that it didn't make sense to proceed with the exchanges until the court sorts through the legal issues. Private insurers will sell insurance on these online marketplaces to both individuals and small businesses.
The problem with Walker's position is twofold.
First, like it or not - and Walker and other Republicans clearly do not like it - health care reform is the law of the land. To shrink from implementing any federal law is risky; the state conceivably could have to give back all or part of a $37 million federal grant to offset the initial cost of the exchanges.
Second, with dozens of decisions required to set up the exchanges, time may not be a luxury the state has. Among the decisions to be made: how much flexibility to give insurers in determining what to cover and what role agents and brokers will play.
Under federal health care reform, the state has to have its plan for implementation in place one year from now. Otherwise, the federal government will set up the exchange for Wisconsin. Even if the state is allowed to continue to work on its plan into 2013, which is possible through a conditional approval, that still gives the public far too little time for input.
"We do not want decisions about Wisconsin's insurance market to be made in Washington," Phil Dougherty, senior executive officer of the Wisconsin Association of Health Plans, told the Journal Sentinel's Guy Boulton recently. The insurers fear they might face stricter regulations under such a scenario than would be imposed by the state.
Essentially, Walker is placing a bet. He doesn't think health care reform will pass constitutional muster. We think he's likely wrong in that assessment. What if the court finds the law is valid? What if the court rules narrowly and strikes down only a portion of the law?
Walker believes that the state could still pull together its exchange by the end of the year if the law is upheld. But we're skeptical, given the number of details that must be decided. And there is another stumbling block: If the law is upheld, the Legislature, now dominated by Republicans, may need to pass a bill to set up an exchange. That likely would mean a long and acrimonious debate that could further delay implementation by the end-of-year deadline.
Originally a conservative idea, well-designed insurance exchanges should make it easier for customers to buy health insurance by allowing comparison shopping and providing a wealth of information for informed purchases. Let's get on with designing the best ones we can.
Should Wisconsin move forward with health insurance exchanges? To be considered for publication as a letter to the editor, e-mail your opinion to the Journal Sentinel editorial department.