Snyder says fed health exchange looms

Senate has not approved a partnership exchange

By David Eggert and Jeff Karoub
Associated Press

DETROIT (AP) — Gov. Rick Snyder warned Monday that time is running out to work with the federal government to establish an online health care marketplace and that people would likely regret lawmakers’ failure to act.

The Republican governor told The Associated Press the GOP-dominated Senate has until week’s end to approve a partnership exchange — a key component of the federal health care overhaul — before legislators go on a two-week spring break. He said there is not enough time afterward, and his administration is talking with lawmakers in an effort to get legislation passed this week.

Snyder said inaction would leave Michigan with a “pure federal exchange” and no state involvement. He said it would mean “worse customer service” for the hundreds of thousands expected to shop for and buy their insurance online starting Oct. 1, with coverage kicking in on Jan. 1.

“In retrospect, if we end up with that, at some point people will look back and most likely regret that decision,” Snyder said.

A partnership would let Michigan handle some customer service functions and approve insurers, which Snyder argues would save them from an extra layer of regulation and prevent the state from having to spend its own money.

“It means worse customer service because what happens in the partnership exchange is we get to handle the customer service piece along with some of the qualification piece. But really it’s the customer service side,” he said. “Wouldn’t you rather be working with a Michigander helping a Michigander understand what they need versus having somebody that the federal government has chosen to be your trusted guide?”

The website and accompanying call center are supposed to make it easier for people to shop for the insurance they must have in 2014. Also open to small businesses, the exchange will be used in part to determine people’s eligibility for Medicaid and, if they buy private insurance through the website, whether they qualify for income-based federal aid to help pay their premiums.

Amber McCann, spokeswoman for Senate Majority Leader Randy Richardville, said it is possible the Senate could vote this week, but Republicans do not see this week as the “make-or-break point.”

“I understand the governor’s desire to see decisive action. There’s still time to talk about this and discuss this a little further,” she said.

McCann said Richardville, R-Monroe, was still getting feedback from the Republican caucus and “we don’t have a clear consensus one way or another.”

The GOP-controlled House last month approved spending a $31 million federal grant for the partnership exchange to be controlled almost entirely by the federal government, with some control reserved for the state. But support has been fading among Senate Republicans in part because of pressure from conservative and tea party groups. A slim majority of Republicans backed a state-controlled marketplace in 2011 before Snyder gave up on the idea because of House opposition in 2012.

At least 364,000 Michigan residents are expected to get private insurance through the exchange in 2014, with many receiving government help to pay premiums. Depending on how many businesses use the website, a maximum of nearly 1.4 million people could be enrolled next year, according to the state Department of Licensing and Regulatory Affairs.

Business organizations are urging the Senate to approve spending the $31 million grant, saying the money is needed for technical compliance and to save the state from having to spend its own dollars. Tea party leaders, however, say no Republican should in any way help implement the federal health law.