Status report: State health exchanges, after Supreme Court ruling

Now that the constitutional questions surrounding the federal health law have been resolved, the ball is largely in the states’ court to establish online insurance marketplaces known as health exchanges — or defer to the federal government.

Prior to the decision, both New Jersey Gov. Chris Christie and Pennsylvania Gov. Tom Corbett indicated they did not want to make any major moves toward health exchanges until after the ruling.

Now, Christie appears to be postponing again.

Last week, in a monthly “Ask the Governor” segment on New Jersey 101.5, Christie seemed inclined to delay action until the fall.

“I think if Mitt Romney’s elected president there won’t be any more Obamacare,” Christie said. “So this is step one in probably what is at least a two-step process this year to see if Obamacare survives.”

Christie said he would take a “wait and see” approach and veto health-exchange legislation if it lands on his desk again.

He also said he would meet any necessary federal deadlines.

Blueprints for state health exchanges are due to the federal government Nov. 16.

Ray Castro, New Jersey Policy Perspective‘s senior policy analyst, said he worries about the state meeting the deadline.

With no authorizing legislation, an oversight board for an exchange cannot be named, he said.

“The board will make a lot of the key decisions in terms of how to move forward,” Castro said. “Until an exchange board is established, and we need legislation for that, it’s going to be limited in terms of how much the state can do.”

Elsewhere in the region, a Delaware official said the state did not “take (its) foot off the gas” in planning for a state health exchange, even through all the legal wrangling over the health law.

Bettina Riveros, chair of the Delaware Healthcare Commission, said they have opted for the federal/state partnership for the exchange because of the state’s small size.

“What we really saw was we didn’t have the population in Delaware to really support a viable exchange without bearing a lot of costs that would potentially be passed on in a per-member, per-month fee,” Riveros said.

There are about 100,000 uninsured people in Delaware.

The federal government will run the exchange, but the state will retain some oversight.

That includes setting essential benefits, reviewing plans and recruiting people for coverage.

Pennsylvania had originally opted for an entirely state-run exchange, but now may move for a similar federal/state partnership as an interim measure.

A spokeswoman for the Keystone state’s insurance department said department representatives will meet with legislative leaders this summer to talk about the exchanges.