|By Wayne Greene, Tulsa World, Okla.|
|McClatchy-Tribune Information Services|
The issue is an incredibly complex one, so perhaps a brief step back is in order.
A health insurance exchange is an electronic supermarket for medical coverage. It's a free-market idea that was created by the conservative
Consumers would go there to compare prices and services and make purchases.
The federal health-care law co-opted the idea and added several elements, all of which are much more controversial than the basic idea.
People who earn up to 133 percent of the federal poverty level -- currently
If they do not receive insurance through their employer, people who earn between 133 percent of the poverty level and up to 400 percent --
A 45-year-old single-person family earning at the top end of the eligibility standards would get an estimated subsidy of
Many employers who do not offer qualifying health insurance are subject to stiff taxes if any of their workers obtain health insurance through an exchange -- one of the main ways the system is financed.
Exchanges -- one for each state -- are integral to the Affordable Care Act, and that has made them a target for opponents of "Obamacare."
Under the law, each state can either build its own exchange or the federal government will impose one on it. Subsequently, federal officials floated a third option, a state-federal partnership with split responsibilities.
When she first came into office, Fallin agreed to accept a
Fallin strongly opposed the federal law as a member of
After a year of studying the issue, legislators again made an attempt at an exchange, although one that clearly would not comply with the federal standards because it would only sell insurance to employers, thus eliminating access to federal subsidies for individuals. Again, the proposal wilted under the heat of tea party pressure.
But Fallin's staff again raised the issue after the presidential election made it clear that the Affordable Care Act wasn't going to be erased by voters.
While the original federal deadline for state decisions on the issue was Friday,
Ramsey said the state is very short on time to put together an exchange at this point, but there are still good reasons why insurance agents should push for a state-controlled exchange, including the right for the state to limit insurance sales to licensed agents and brokers.
Obamacare opponents are again pressuring the governor not to be part of an exchange.
An exchange is the "cornerstone of Obamacare" and building one is the beginning of compliance with a law that the state should continue to resist, she said.
If the state establishes an exchange and accepts expanded
"We believe we need to stand with governors like
Advocates of a health insurance exchange are also encouraging their supporters to call the governor's office.
The number for the governor's office is: 405-521-2342.
Vuillemont-Smith said she is also concerned that taking part in an exchange would undercut Attorney General
Pruitt's challenge, which is currently pending in federal court in
Insurance companies who would see their sales rise through the exchanges and the law's mandates for almost everyone to have health coverage would also be big winners, she said. "Wouldn't you like to have a business where the government helps people buy your services?" she said.
The big losers might be insurance brokers, whose role as insurance middlemen could disappear in an exchange and employers who are determined not to provide qualifying coverage to their workers, she said.
What's your subsidy?
The Kaiser calculator can be found at tulsaworld.com/subsidycalculator.
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