The fight over President Barack Obama’s health care overhaul is playing out on the state level.
A key component of the 2009 law is the requirement that states set up health care exchanges, or regulated marketplaces where individuals or small businesses can purchase plans from private insurers. Because the Senate Republicans have hesitated to pass legislation that would set up the exchange, and don’t want to come back to session before January to deal with the measure, millions in federal funds hang in the balance, some warn.
“I’m very concerned,” Assemblywoman Addie J. Russell, D-Theresa, said at a news conference in September. “There’s federal funding, and the states are required to act in a certain amount of time. This issue was not completely resolved, so I think it’s extremely important.”
That the bill stalled in the state Senate signals the wariness, even on a local level, that Republicans have in embracing Mr. Obama’s health care overhaul, even when federal funds are at stake.
Late in the legislative session in June, the Assembly, Senate and Gov. Andrew M. Cuomo had negotiated a bill that would have created the health care exchange. But individual Republican lawmakers signaled an unwillingness to pass the legislation because of the stigma associated with “Obamacare,” according to a report in The New York Times.
State Sen. Patricia A. Ritchie, R-Heuvelton, said she doesn’t think the Senate should come back in session before the next time it is scheduled to do so — in January — to deal with the measure.
“I’m not a big fan of government bureaucrats making decisions that individuals and businesses would be making,” Mrs. Ritchie said.
The three sides will have to hammer out another compromise.
Asked what she’d like to see from the compromise, Mrs. Ritchie said: “I’m kind of taking a wait and see approach. I’m not a big fan of government running health care ... I think personally the best thing is to open up the state lines for competition.”
Because of varying state-by-state regulations, New Yorkers can’t buy health care plans from Oregon, for example. If they could, Mrs. Ritchie argued, competition would increase and prices would decrease as a result.
Critics of opening state lines for competition, though, argue that health insurance companies will flee to states with the least restrictive regulations, which would harm health care standards.
There is also contention over whether the state actually could lose federal funds.
As part of Mr. Obama’s health care law, states are awarded money to help set up exchanges. New York, where 2.7 million people are uninsured, was awarded a preliminary grant. There’s another round of funding coming. That’s basically where the agreement ends.
“The next deadline is June 2012,” Mrs. Ritchie said.
But H. Blair Horner, the vice president for advocacy at the American Cancer Society in New York and New Jersey, said that doesn’t paint the full picture about deadlines. The next deadlines are on a rolling basis. One passed at the end of September. The next will pass on the new year, and the final deadline is in June.
But with a congressional committee looking to cut $1.2 trillion from the federal budget, that money could be taken from the kitty, Mr. Horner warned.
“If they pass it by June, which would be warp speed, and the money hasn’t been vaporized, then Senator Ritchie’s office would be right,” Mr. Horner said. “But that’s a big if.”
While Mrs. Ritchie signaled a willingness to negotiate, other Republicans are more steadfast in their disapproval of the exchange.
“I’m opposed to the health care exchange because it’s basically New York state’s version of Obamacare,” Assemblyman Kenneth D. Blankenbush, R-Black River, said in a statement. “It’s another job-killing tax that hurts small businesses.”
But if the state doesn’t act, the federal government will just set up the exchange for it.
“We don’t like that idea,” Mr. Horner said. “Is the federal government going to have an off-the-shelf health insurance exchange that will meet the diverse needs of a big state like New York? You have different capacity issues in Watertown than they do in the Bronx.”