Some states resisting health care overhaul
RALEIGH, N.C. — With new online health insurance exchanges set to launch Tuesday, consumers in many Southern and Plains states will have to look harder for information on how the marketplaces work than their counterparts elsewhere.
In Republican-led states that oppose the federal Affordable Care Act, the strategy has ranged from largely ignoring the health overhaul to encouraging residents not to sign up and even making it harder for nonprofit organizations to provide information about the exchanges.
Health care experts worry that ultimately consumers in these states could end up confused about the exchanges, and the overall rollout of the law could be hindered.
“Without the shared planning and the cooperation of the state government, it’s much harder for them to be ready to implement this complicated law,” said Rachel Grob of the University of Wisconsin-Madison, who has studied differences in how states are implementing segments of the law.
Several of the 14 Northeast, Midwest and Western states running their own insurance exchanges have spent weeks on marketing and advertising campaigns to help residents get ready to buy health insurance.
By contrast, most states across the South have declined federal grants to advertise the exchanges and ceded the right to run the marketplaces themselves.
Governors from the Carolinas to Kansas have decried the exchanges and the rest of the law, which was passed by Congress in 2010 and many argue reaffirmed when voters re-elected President Obama in 2012. The Supreme Court in 2012 upheld the constitutionality of most of the law; a piece of the Medicaid expansion was an exception.
“When it came to Obamacare, we didn’t just say ‘no,’ we said ‘never,’” South Carolina Gov. Nikki Haley said last month alongside U.S. Sen. Tim Scott, whom she appointed last December when Jim DeMint resigned. “And we’re going to keep on fighting until we get people like Sen. Scott and everybody else in Congress to defund Obamacare.”
Others have gone beyond fiery rhetoric. Missouri’s lieutenant governor urged residents to refuse to sign up for federal health insurance. In Florida, state officials ordered county health departments to bar from their property navigators hired under federal grants to explain the plan’s complexities. Broward County commissioners last week ignored that ban and voted to allow navigators and other counselors into county offices, including health departments.
In places where state officials have declined to disseminate information, the work is left to nonprofit organizations and word-of-mouth among consumers.
Asa Gregory, 36, of Wilson, N.C., works sporadically as a substitute public school teacher and has lacked health insurance for seven years, paying the medical bills after a traffic accident with help from his parents.
“I would like to have health insurance. I think that’s a no-brainer,” he said.
Gregory said he’s been checking out the government’s information web site at www.healthcare.gov but feels “there’s certainly quite a bit for me to learn.”
“I’d say, percentagewise, what do I know about what’s happening on October 1st? I’d say maybe 40 percent,” he said. “I’m not confident that I know a majority of the information, but it’s gathering, and I’m looking at it. I’m preparing for the opportunity of the marketplace.”