Neither Kansas nor Missouri will be involved in setting up a health exchange, according to announcements by both governors Thursday.
Exchanges are online marketplaces where people will soon go to compare and shop for health plans. The federal health law requires an exchange in every state.
States must indicate by next week whether they or the federal government will set up and run their exchange. Missouri Governor Jay Nixon said having a federal exchange is not ideal, but Missouri voters passed Proposition E Tuesday, which prohibits the state from setting one up without legislative approval.
"Regulating the insurance market is a power best left in hands of the states, where we can perform those duties more efficiently and effectively and provide better service for our consumers,” Nixon said at a news conference earlier today. “But based on current state law and the federal deadline, the state-based option isn’t on the table for Missouri at this time.”
The health law has been widely unpopular in Missouri. A bill that would have authorized a state exchange stalled last year, and state lawmakers haven’t taken any action on one since then. They don't convene again until January.
Thomas McAuliffe, a policy analyst with the Missouri Foundation for Health, says just because the federal government runs an exchange at the onset, doesn’t mean the state couldn’t get involved later.
“I would think that the federal government really doesn’t want to be involved in perpetuity for running the exchange in Missouri or Arkansas or Iowa or any of those states,” says McAuliffe. “So there’s going to be a lot of incentives.”
Across the state line, Governor Sam Brownback said today that Kansas will have no involvement in running one either.
“Kansans feel Obamacare is an overreach by Washington and have rejected the state’s participation in this federal program," Brownback said in a statement. "My administration will not partner with the federal government to create a state-federal partnership insurance exchange because we will not benefit from it and implementing it could costs Kansas taxpayers millions of dollars."
The state's insurance commissioner, Sandy Praeger, had been pushing Kansas to take a role, arguing the state knows its marketplace and health needs best.
About a dozen states have said they plan to run their own exchanges. At least eight states have said they won’t. The rest have yet to submit plans.
This story is part of a reporting partnership that includes KCUR , NPR and Kaiser Health News.
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