The federal government will set up and manage a health exchange in Missouri. An exchange is an online marketplace where individuals and small businesses will soon shop for health plans. The Affordable Care Act, or obamacare, requires that all states have exchanges up and running by 2014. States have until next week to indicate whether they will run one or not. Missouri Governor Jay Nixon says that fast-approaching deadline and the passage of proposition E on Tuesday, preventing the state from establishing an exchange without legislative approval, means Missouri won’t have a role in an exchange.
He says it’s not ideal: “Regulating insurance market is a power best left in hands of states where we can perform those duties more efficiently and effectively and provide better service for our consumers,” says Nixon. “But based on current state law and the federal deadline, the state based option isn’t on the table for Missouri at this time.”
Thomas McAuliffe, a policy analyst with the Missouri foundation for health, says just because Missouri isn’t running its exchange at the onset, the state could still 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 arkensas, so there’s going to be a lot of incentives.”
Efforts to set up a state exchange stalled in the legislature two years ago. Lawmakers haven’t taken action since. They convene in January. 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.