COLONIAL HEIGHTS — The U.S. Supreme Court ruling upholding the federal health care reform law doesn’t accelerate the need for a Tennessee special legislative session to consider establishing a state health care exchange, Lt. Gov. Ron Ramsey said Thursday.
Ramsey, R-Blountville, said outside the annual Kingsport Area Chamber of Commerce legislative barbecue event that lawmakers still have time during next January’s session to act on the health care exchange provision in the reform law known as the Affordable Care Act.
Health insurance exchanges are, for most states, new entities that will function as a marketplace for buyers of health insurance and give them choices for health coverage, according to the National Conference of State Legislatures (NCSL).
Tennessee could establish one or more state or regional exchanges, partner with the federal government to run the exchange, or merge with other state exchanges.
If a state chooses not to create an exchange, the federal government will set up the exchange in the state, according to the NCSL. The exchanges will offer a variety of certified health plans and must be up and running in 2014 barring a repeal of the law by Congress.
Gov. Bill Haslam’s administration, in a policy document, feared insurers might not participate in the state exchange; or the exchange would be unable to handle consumer demand; or employers would drop coverage.
As of June 5, the NCSL said 10 states and the District of Columbia have enacted legislation to establish state-based health insurance exchanges, while three states have established an exchange by executive order.
Ramsey said it’s important the high court rejected the portion of the law authorizing the government to penalize states that do not accept an expanded eligibility provision for Medicaid.
“(Former) Gov. (Phil) Bredesen called this the ‘mother of all unfunded mandates’ if we had to do that,” Ramsey said of the Medicaid expansion.
But, Ramsey pointed out, the state is well-positioned to take on the law’s costs.
“This year, we know we’ve overcollected about $400 million above projections,” Ramsey noted. “There was lots of temptation and screaming and yelling that we needed to be spending that before leaving session, but we didn’t. ... We held it in the Rainy Day Fund (a reserve account).”
Ramsey also admitted the Supreme Court ruling caught him off guard.
“I thought they would rule the (individual) mandate unconstitutional,” he said. “There is some irony in the fact that President Obama argued and argued the law wasn’t a tax, and then they found it constitutional based on the fact it was a tax.”
Ramsey also indicated the ruling doesn’t mean the presidential election is in the bag for GOP challenger Mitt Romney.
“I think either way would have been bad for Barack Obama,” Ramsey said. “If it had been ruled the other way (rejection) then the hallmark of his administration’s first four years was out the window. But now I do think for both sides, this will be the rallying cry for the fall. I could make the case this could help Obama in fund raising, so I’m not sure whether it’s good or bad for us as a party. I’m just worried about what it does for us as a country.”
For more about Tennessee’s preparation of a state health insurance exchange go to www.tn.gov/exchange.