Michigan will not have its own state-based health exchange after House Republicans shot down one last attempt to create one Thursday, paving the way for the federal government to come in and control it, with much less state oversight and involvement.
After the state House Health Policy Committee voted down a bill that would have created a state-based health insurance exchange, some committee members held out hope a deal could be worked out.
A few hours later, House Speaker Jase Bolger, R-Marshall, put an end to it once and for all.
"It was my hope the committee would find that a state-run exchange afforded us more control over the unacceptable over-reach by the federal government regarding the health care of Michigan citizens," Bolger said in the statement. "After due diligence, however, it is clear that there were too many unanswered questions for the committee to feel comfortable with a state-run exchange and we will not have one in Michigan."
Rep. Gail Haines, R-Lake Angelus and chairwoman of the committee, voted yes on SB 693 — to audible groans from those packed into the hearing room. But the measure failed on a 9-5 vote, with two abstentions.
A motion then was made to reconsider the vote, which Haines moved to pass for the day and then adjourned the meeting. Afterward, Haines said many of her members still had unanswered questions.
Attorney General Bill Schuette praised Bolger's decision.
"I applaud and appreciate Speaker Bolger's wise decision to halt the vote on implementation of a state-run health insurance exchange. I have always had grave concerns about establishing a health care exchange. This is an extremely complex issue," Schuette said in a statement. "In my discussions with other attorneys general and legal experts, we agree that many unanswered questions still remain, especially with regard to future costs to Michigan taxpayers and the practical and legal impact of looming federal mandates."
A new version of the bill the committee debated Thursday would have tie-barred its passage to a two-bill package — House Bills 4143 and 4147 — that would prohibit qualified health plans from covering elective abortions. An amendment to remove the tie bar failed along party lines.
At the beginning of the hearing, the committee heard testimony from a variety of individuals attempting to revive the fight over the Patient Protection and Affordable Care Act — commonly known as Obamacare. They argued the same points opponents have made since the Senate passed SB 693 a full year ago.
SB 693 would create a state-based exchange, referred to as the MI Health Marketplace. Gov. Rick Snyder, who has been urging the House to approve the bill since last year, has referred to a state exchange as a Travelocity-type website where people looking to purchase health insurance could shop for the best price and plan.
The House waited for a year to take action on the bill, first to see how the U.S. Supreme Court ruled on the constitutionality of the law. When the ruling to uphold the law came down in late June, House members continued to wait.
Schuette supported inaction by the House then, saying action was unnecessary until after the election because Republican presidential candidate Mitt Romney had pledged to repeal the Affordable Care Act if elected president.
When that didn't happen, either, House Republicans were back to where they were a year ago —having to decide whether it was best to have some say over how the exchange would operate in the state or let the federal government come in and run it.
When it became clear the House was not going to move on the bill, Snyder in August said he was scrapping the idea and moving forward with a state-federal health exchange.
Then this month, the governor said he had filed a grant application with the U.S. Department of Health and Human Services that it would move forward with the state-federal arrangement but that the state might exercise its option for a state exchange.
by Chris Gautz
Crain's Detroit Business