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COLUMBUS, Ohio - A major decision is expected any day that will determine how the state will implement a key part of the Affordable Care Act.
By Friday, Ohio must announce whether it will set up a state-run health-insurance exchange or let the federal government operate it. An exchange is a place where consumers and small businesses can compare and shop for private health insurance. Amy Rohling McGee, president of the Health Policy Institute of Ohio, says the state could also choose a “hybrid” model and maintain some control of the exchange.
"The hybrid approach would offer the state the opportunities to still retain the plan-management functions of the exchange, or the consumer-assistance functions of the exchange, or both."
McGee says that approach would also allow Ohio to possibly set up a state-run exchange in the future. Gov. John Kasich hasn't announced a decision, but it's unlikely a state-run exchange is in the cards. No matter who runs it, Ohioans should be able to purchase insurance directly from the exchange in 2014.
McGee says it's difficult to assess which is the best way to go. From a cost perspective, she says, an exchange run by the federal government might make the most sense. But she points out that Ohio leaders might have better oversight of a state-run exchange and could monitor compliance.
"There are states that have seen value in having the state running this; more control within the states over the insurance markets and just how the exchange is designed."
President Obama recently announced that while states must still say by Nov. 16 whether they plan to build their own marketplace, they can now wait until Dec. 14 to submit their plans. An estimated 12 million people are expected to get insurance through the exchanges.
A recent policy brief on the exchanges is online at healthpolicyohio.org.
