Democratic state lawmakers are proposing legislation that would expand the state’s Medicaid program and establish a state-run healthcare exchange. While Medicaid expansion remains somewhat of an open question, GOP lawmakers say a state exchange will not happen at least for now.
The federal Affordable Care Act mandates the creation of healthcare exchanges, a kind of marketplace for insurance companies and consumers, in each state. The exchanges can either be run by the state, the federal government, or a collaboration between the two.
Indiana University law professor David Orentlicher says there is little incentive for states to take part, because if there are issues with the exchanges early on, state lawmakers don’t want to shoulder the blame.
“So if you’re an elected official and the federal government’s there to take the heat, so I think that’s what’s driving a fair number of states to let the federal government do it,” Orentlicher says.
House Ways and Means chair Tim Brown says holding off on running an exchange is a settled question for now.
“I think as we continue to look at how other states are doing it, we could always reevaluate. Hopefully we can learn from other states,” Brown says.
Governor Mike Pence has said since his campaign he wants the state to take no part in running an exchange.