Competition key ingredient to success of state health exchanges

Stateline reports that even some of the strongest health exchange enthusiasts are concerned that some states will still only have limited insurance choices for consumers. Meanwhile, in other news, the Arkansas Medicaid expansion model gains momentum, Florida's efforts face continued complications, Arizona's expansion standoff continues and the Missouri Senate rejects the concept. Also, the shape of Ohio's compromise exchange is beginning to emerge.  

Stateline: Lack Of Competition Might Hamper Health Exchange
The White House sums up the central idea behind the health care exchanges in the new federal health law with a simple motto: "more choices, greater competition." But even some stalwart supporters of the Affordable Care Act worry that in many states, people won't have a lot of health insurance choices when the exchanges launch in October. Health economists predict that in states that already have robust competition among insurance companies-;states such as Colorado, Minnesota and Oregon-;the exchanges are likely to stimulate more. But according to Linda Blumberg of the Urban Institute, "There are still going to be states with virtual monopolies" (Vestal, 4/23).

Health News Florida: 'Private Option' Plan, Florida Model, Passes In Ark.
Arkansas' state legislature passed a model plan to expand Medicaid last week, even though its Legislature is dominated by Republicans and the measure had to pass by a three-quarters vote, the Associated Press reports. The Arkansas plan is the model for Florida state Sen. Joe Negron's plan, which would accept an estimated $51 billion in federal funds over 10 years to expand insurance to about 1 million of the state's low-income uninsured (Gentry, 4/22).

Miami Herald: Legislators Poised To Adjourn With No Medicaid Plan
As the clock winds down on the legislative session, Florida lawmakers are sending signals that they are likely to adjourn without resolving the issue of whether to accept federal Medicaid money to insure the state's poorest residents. "It's not something you put together in a week,"' said Sen. John Thrasher, R-St. Augustine, chairman of the Senate Rules Committee and a close adviser to Senate President Don Gaetz. "It's a very big, complicated issue and these issues take some time." He said he does not expect there would be political repercussions if the Republican-led Legislature waits another year (Klash, 4/22).

Arizona Republic: Brewer, GOP In Medicaid Standoff
Three months after she stunned political observers and made her case for expanding Medicaid coverage in Arizona, Gov. Jan Brewer is no closer to reaching agreement with Republican legislative leaders on the issue, which has driven a wedge through GOP ranks and is delaying work on the state budget. By most accounts at the Capitol, Brewer has just enough votes in the House and Senate to get expansion approved. Even some lawmakers who oppose the plan predict it eventually will pass, owing in large part to the power of the governor's veto pen and her reputation for tenacity, as well as pressure from top-flight lobbyists and heart-tugging health-care crisis stories (Reinhart, 4/22).

The Associated Press: Mo. Senate Votes Down Federal Medicaid Expansion
Republican senators have made it clear that there will be no Medicaid expansion in Missouri this session. The Republican-led Senate voted down a Democratic attempt Monday night to insert $890 million of federal funds into Missouri's budget to expand Medicaid eligibility to an estimated 260,000 lower-income adults (4/23).

Cleveland Plain Dealer: Ohio's Medicaid Expansion Alternative Could Use Private Insurance
For the first time since Gov. John Kasich won national attention by supporting Medicaid expansion, a clear picture is emerging on how the Republican governor's compromise with federal regulators could work. Some uninsured Ohioans would be enrolled in the state's traditional Medicaid program, while others would sign up for private health insurance using federal funding, said Greg Moody, director of Ohio's Office of Health Transformation. The proposal, which Kasich hopes to sell to GOP lawmakers reluctant to support an outright Medicaid expansion, has been dubbed "The Ohio Plan." And it differs from the standard federal expansion program on one crucial point: It puts some enrollees in the private insurance market (Tribble, 4/22).