Gov. Terry Branstad’s handling of Iowa’s preparations for the Affordable Care Act strike us as being reminiscent of a school kid who skips homework in anticipation of a certain snow day, only to find no snow come morning.
The ACA, or Obamacare, was signed into law in March 2010. A major provision calls for creating state-by-state health insurance marketplaces, or exchanges, where small businesses and consumers can compare private plans. The law allows states to create their own exchanges, let the federal government do it or craft a partnership. States were required to pick their path by Nov. 16.
Many Republican officials, including Branstad, were convinced that the U.S. Supreme Court would strike down the law as unconstitutional. Instead, the court left much of the law intact.
At that time, Branstad said his administration would work to create a state insurance exchange. But not much happened as Branstad and other GOP leaders waited to see if Republican nominee Mitt Romney, who favored ACA repeal, would win the presidency and if their party would take over Congress. Neither happened.
So as a deadline approached, Iowa had not yet decided whether to create its own exchange, let the federal government construct it or form a partnership. Branstad’s office responded to the deadline with more criticism of Obamacare and a long list of questions for federal officials. Many on the list were good, solid questions. Good, solid questions that could have been asked months ago amid a serious effort to prepare Iowa’s exchange plans.
The federal government moved its deadline to Dec. 14. State Sen. Jack Hatch, D-Des Moines, an advocate of creating a state-crafted exchange, insists that Branstad could call lawmakers back for a special legislative session to hammer out an exchange before the deadline. But anyone who knows how the Legislature works and how politically complicated crafting an exchange deal would be, can see that Hatch’s overture is mostly about scoring political points.
Unless something changes, rapidly, Iowa will probably end up with a federally created exchange, at least initially. And that’s unfortunate. Iowa would have been better off tailoring a marketplace to fit the needs of its citizens and businesses. We should have done our homework.
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