Another roadblock for Missouri health exchange

Jan 11, 2012

Last session, Republicans in the Missouri Senate blocked the creation of a state-run health insurance exchange. The online insurance marketplace is required under Obama's health reform law, but has become a political football in states like Missouri, with a Republican-controlled legislature. In this week's Health & Wealth update, Republican senators move to put one more roadblock on the path to a state exchange.

Republican senators say Governor Jay Nixon is intent on setting up a state-run health insurance exchange, with or without legislative approval.

The kerfuffle began in September. A Senate committee was hearing public testimony on health exchanges. Meanwhile, the insurance commissioner appointed by Governor Nixon, a Democrat, was holding a vote to accept federal dollars to lay the groundwork of a health exchange.

"We ran over to their meeting, and let them know where we stood on that," said Rob Schaaf, Republican senator from St. Joseph. "We didn't think that they should move forward without the legislature."

Now, Schaaf has introduced a bill that would bar the governor from moving ahead with an exchange without legislative action. Schaaf opposes the creation of an exchange, saying it will cost the state money with no added benefit. "I mean, there's already, in essence, a virtual exchange out there now," he said. "It's called brokers. You can go to your broker, and he can shop around for you and get you the best deal. Having the government run it isn't going to make it more efficient."

Yesterday Schaaf presented the bill to the Senate Small Business and Insurance Committee, where it was warmly received by committee Chairman Scott Rupp.

"We're just saying to the governor, this is not your role," Rupp told me. "This is a legislative role. Take Obamacare out of it, whatever -- this is just saying this is a legislative issue, like so many others."

Whatever happens with Schaaf's bill, the Senate seems unlikely to OK a state exchange. Rupp says the mood in the Senate is now firmly against creating an exchange. The U.S. Supreme Court will rule this spring or early summer on the legality of the Affordable Care Act, and Rupp said Missouri lawmakers should hold off until after that decision.

"If they strike down the whole law, then we walk away, so there's really no point in having the discussion until we have all the information," said Rupp. "It's a moot point even trying to move forward."

The lone voice of dissent at yesterday's hearing was that of Allen Ladage, a retired pastor and a member of Missouri Health Care for All. He said with all this fighting over Obamacare, lawmakers are losing sight of the real issue: "It shouldn't take all this political maneuvering and bickering back and forth. Good health for everyone is a right. It is a God-given gift."