A lively crowd turned out in Omaha on Monday to quiz state insurance officials about the insurance exchanges that are a key part of the federal health care overhaul.
Close to 150 people attended the seventh in a series of meetings being held across Nebraska to gather public opinion about the state's options under the controversial law. Officials are seeking input on whether Nebraska should operate its own exchange, defer to the federal government or choose some type of hybrid model.
Nebraska's options were only a small part of the discussion Monday, and the crowd was clearly divided.
One man's call for a state-run exchange drew applause and a “hear, hear” from the group.
But there also were people such as Jill Woodward, who said she wants to see the whole law overturned.
“I didn't want any of it to begin with,” she said.
David Corbin, a retired University of Nebraska at Omaha professor, said he was leaning toward a hybrid model after hearing the night's presentation.
There could be economies of scale in having the federal government handle all the information technology requirements, he said. But Corbin questioned how the state would make its decision and whether it could be ready to implement an exchange by the Jan. 1, 2014, deadline.
Questions from the crowd ranged from the general, such as whether the exchanges would still be required under a new president, to very specific, such as how part-time employees would be counted in determining whether an employer qualified as a small business.
In regard to the first question, Eric Dunning, the State Insurance Department's legal counsel, said he couldn't speculate. In response to the second question, Martin Swanson, the department's assistant director, said he has yet to analyze the newly released federal regulations.
Some people in the audience worried about how much influence insurance companies would have in a state-run exchange.
Others complained about their tax dollars going to subsidize people who don't have insurance now, which drew protests from a woman who said she doesn't have insurance because she can't afford what her employer offers.
Under the federal law, insurance exchanges are to be places where people can go to compare and buy health insurance. Subsidies to purchase insurance will be available only through the exchanges.
States must notify the federal government by Nov. 16 whether they will proceed with a state-run exchange.
Swanson said 13 states so far have said they plan to operate their own exchanges, while 26 have said they will let the federal government handle all or part of the job.
Gov. Dave Heineman, who adamantly opposes the federal health care law that created the exchanges, has said he wants to hold off on that decision until after the presidential election.
In the meantime, he has instructed state insurance officials to plan as if the state will run the exchange.
J.P. Sabby, one of the insurance department planners, showed one product of their work Monday — one of 24 detailed diagrams of the steps needed to process an application under a state exchange.
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