Missouri has less than 24 hours to decide whether it wants to join with the federal government to set up a health exchange in the state.
Gov. Jay Nixon told U.S. Department of Health and Human Services last November that state law prevents him from moving forward with anything without legislative approval. And, there doesn’t appear to be much traction among state lawmakers.
Speaking near Kansas City last week, Nixon said not doing anything with an exchange is a missed opportunity, and he hopes that will change. But he says for now, his primary focus is on pushing for an expansion of Medicaid in the state.
"I don’t mean to say that the health exchange is not important, I think having that opportunity especially for small businesses to purchase competitive priced tailored insurance on an exchange is a good thing," Nixon said. "But in the zone of what we’re at right now, getting back Missourian taxpayer dollars that could have sig and immediate effect starting Jan. 1 of 2014 under a Medicaid expansion, is under a hierarchy of focus for me."
Under the federal health law, states face two major decisions: whether to take part in a Medicaid expansion, and whether to set up and be involved in operating a health exchange.
HHS says at least 20 states so far have indicated that they’ll set up their own exchange or run a partnership one.