Wednesday, September 11, 2013

Keep your Obamacare off my exchanges

After reading the recent news story about a man at a Kentucky State Fair who expressed interest in Kentucky's new health-care exchange program, Kynect, by saying he hoped it beat Obamacare, apparently not realizing it was Obamacare, I decided to take a look at Kynect's website. What I found was that it seems to encourage exactly this sort of ignorance. Nowhere on the website is there a single mention of the words Obama, Obamacare, or the Affordable Care Act. The FAQ makes just one fleeting reference to federal law (regarding the requirement to purchase insurance) and then makes it sound like it was the governor, Steve Beshear (a Democrat, for what it's worth), who unilaterally chose to set up the exchanges:
Why was [Kynect] created?

Governor Steve Beshear issued an executive order to create a state-based health benefit exchange to best meet the needs of Kentuckians. kynect, like other health benefit exchanges, will provide simple, one-stop shopping for individuals and small businesses to purchase health insurance and receive payment assistance or tax credits.

In contrast, the website for the exchange program in New York (where I live) says right upfront that it's a result of the ACA:
Under the federal Affordable Care Act, an Exchange will be operating in every state starting in 2014. States have the option to either set up an Exchange themselves or to allow the federal government to set up an Exchange in their state. New York has chosen to set up its own Exchange, called the New York Health Benefit Exchange. On April 12, 2012, Governor Cuomo issued Executive Order #42 to establish it within the NYS Department of Health.
This made me curious about whether there's some relationship between a state's political composition and how candid its exchange website is about its connection with the ACA. I did a little online research about the different state exchanges that have been set up (this webpage was particularly helpful), and my discovery was a bit anti-climactic: it turns out that almost all of the states that have set up exchanges were ones that voted for Obama in 2012. Kentucky, which Obama lost by 23 percentage points, is the one exception. Maybe not so surprisingly, it also has the only exchange website where the words "Affordable Care Act" are nowhere to be found (though in a few other states such as Minnesota and New Mexico, mention of the law is buried deep within the website, and not, say, in a FAQ or "About Us" section). It will be interesting to watch how the law will be sold in other red states, where ironically the exchanges will be mostly federal-run due to the GOP's dogged unwillingness to cooperate with the law's implementation. Will the feds also adopt the principle that it's better to avoid disclosing the source of this cool new policy in the name of getting more people into the system?

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