LINCOLN — Nebraska’s three largest health insurers urged Gov. Dave Heineman on Thursday to opt for as much state sovereignty as possible with health insurance exchanges.
At a meeting about implementing federal health care reform, top officials of Blue Cross Blue Shield of Nebraska, Coventry Health Care of Nebraska and United HealthCare all said they favor having the state operate an exchange.
“We’d like to stay in the fight, not throw in the towel,” said Steve Martin, Blue Cross president and CEO. “If we throw in the towel, we’ll get what we get” from the federal government.
Under the controversial 2010 federal health care law, insurance exchanges are to be places where individuals and small businesses can get help buying private health insurance. Federal subsidies will be available through the exchanges for those who need financial help.
The law allows Nebraska to operate its own exchange, defer to the federal government or have a joint state-federal exchange.
Going with a state-run exchange would give Nebraskans the best chance to decide such matters as what plans can be sold through the exchange, the minimum benefits required of such plans, the role of insurance agents, and how to pay for administrative costs of the exchange, the insurance officials said.
To pay those ongoing operational costs, they suggested using the premium tax money that now goes to subsidize the state’s high-risk health insurance pool, along with charging fees to insurance customers.
The high-risk pool won’t be needed after Jan. 1, 2014, because the federal law will bar insurance companies from refusing to cover people with pre-existing health problems.
Heineman said last year that he doesn’t want a federally run exchange in Nebraska, calling it a federal takeover of the state’s health care system.
More recently, he has sounded skeptical about doing a state exchange, saying the only decision left to states under the law is “who to tax and how much.”
Heineman has said he would wait until after the Nov. 6 election to make that decision. State officials must notify the federal government by Nov. 16 of Nebraska’s choice.
The Nebraska Department of Insurance set up a series of meetings in August and September to gather public opinion.
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