Locals advise on health care exchanges

BY CHELYEN DAVIS

The Supreme Court’s ruling last week upholding much of the federal health care law sets in motion a number of decisions for state governments.

Should they set up their own health care exchange, where individuals and small businesses can go to get cheaper health insurance?

Should they expand Medicaid eligibility, which would help cover the lower-income uninsured but would cost the states millions of dollars?

In Virginia, two Fredericksburg-area men are helping plan for how the state should handle the health care exchange, should lawmakers decide to do so.

State Sen. Richard Stuart, R-Stafford, was appointed earlier this year to the governor’s Virginia Health Reform Initiative’s advisory council, and Fredericksburg businessman Joe Wilson has been a member of the council since it was started after the health care law was passed.

Stuart said the council has been hearing input from various groups–insurance companies, businesses, advocacy groups, patients’ rights groups, doctors, hospitals, “everybody imaginable that would have a stake in this health benefits exchange.”

The council won’t be deciding if Virginia should run its own exchange, but will make recommendations on what such an exchange should look like–whether it would be run through the State Corporation Commission or its own agency, how it would be run, etc.

Several state legislators filed bills in the 2012 legislative session to create an exchange, but those were shunted to a Senate subcommittee on which Stuart sat for study while lawmakers waited to see how the Supreme Court would rule.

By next year’s session, Stuart said, the legislature will need to decide how to act on those bills.

He and Wilson both said they and the majority of the advisory council favor setting up a state-run health care exchange, if the alternative is a federal one.

“From my perspective and most others, we would want to do our own exchange. We would not want to have the feds impose one on us,” Stuart said. “We’d want it to be our own creation.”

Wilson said he thinks Virginia is further along than many states in planning for an exchange.

“We probably have a skeleton that we could put some meat on at this point, and a lot of states haven’t really done anything,” Wilson said.

He said the advisory council so far favors a state-run exchange that’s “quasi-governmental,” with both government and private insurers running it, and possibly an advisory board overseeing it.

That is, of course, if state leaders want to create the exchange. Wilson estimates the chances of that as 50-50.

“The big question at this stage of the game is whether or not the General Assembly will see any benefit in our efforts and recommendations and whether the General Assembly will decide to initiate an exchange,” he said. “We’re strictly advisory, so all we can do is make recommendations.

” In my mind, [the chances are] 50-50 that the General Assembly would decide to move forward and establish an exchange.”

Last week, the federal government announced additional, later deadlines for states to apply for grants and create exchanges, which means Virginia can wait until the 2013 session to decide what to do.

Urged by some state Democrats to call a special legislative session to deal with the exchange issue, Gov. Bob McDonnell said he would not, because of the later deadlines. But he also wants to wait and see what happens in this November’s elections.

McDonnell, like many Republicans, hopes that the elections will put in office a Republican president and Senate majority, and that those new leaders would then repeal the health care law.

“To me, the prudent course is to continue planning here in Virginia [and] wait and see what happens in November,” McDonnell said in an interview on WNIS radio in Norfolk this week. “We don’t want to waste the taxpayers’ money building an exchange that may not need to be put in place.”

Chelyen Davis: 540/368-5028

Email: cdavis@freelancestar.com

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