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State insurance commissioner backs health exchange

Every Mississippi Republican in state office is in lockstep with GOP presidential standard-bearer Mitt Romney in advocating total elimination of what their camp calls Obamacare, right? Wrong.

State Insurance Commissioner Mike Chaney sees one particular component of the Affordable Care Act - the health insurance exchange, an online insurance marketplace on comparable rates and provisions - as a crucial tool to broaden health care of Mississippians. Moreso, Chaney has taken steps to see that it is implemented, gathering proposals of companies that would enter the exchange.

Though a frontal legal attack by 26 Republican governors on the act's constitutionality in a lawsuit is aimed at ACA's federal mandate for everyone to buy some form of health insurance, many believe the insurance exchanges are really at the heart of the reform measure pushed by President Barack Obama.

The U.S. Supreme Court is expected to rule before the end of the month. Even if it strikes down the entire law, the thinking here is Mississippi will keep the health insurance exchange.

Chaney said the health exchange is "not a Republican idea or a Democratic idea, it's a universal idea," and reasoned that it is far more preferable for the state to operate an exchange rather than have a "one size fits all" system imposed by the federal government as would happen in 2014 if a state does not put one in place.

In any case, with Chaney's initiative the state will be in far better shape than neighboring Louisiana, which according to a New York Times survey, is one of only two states that have taken no steps toward establishing an exchange. "They (Louisiana) will regret it," one Mississippi Insurance Department person observed.
As for Romney, his current campaign to repeal Obamacare is a marked reversal from his Massachusetts gubernatorial administration when he sponsored an almost identical universal health care law, which included an insurance exchange, as well as the maligned individual mandate. Earlier this week, the Wall Street Journal disclosed previously missing emails confirming Romney's advocacy of the individual insurance mandate.

The Center for Mississippi Health Policy has estimated that 275,000 Mississippians now without health care coverage will enroll in coverage through an exchange when ACA is implemented in 2014. Under the health reform's federal subsidies to help poorer persons purchase insurance, the center estimates that 229,000 state citizens will be eligible for premium subsidies, injecting $900 million into the state's economy. Add to that some 270,000 new Medicaid recipients who would become eligible if that component of ACA is left standing.

Chaney, a former longtime state legislator who is in his second term as insurance commissioner, has been out front since 2009 for the health insurance exchange idea. Though the Legislature several times failed to enact enabling legislation (backed by Gov. Haley Barbour) to implement an exchange, Chaney found under a little-known legislative rule that he could institute the program by administrative fiat. So that's what he did, accepting some $22 million in federal start-up funds.

While Chaney knows some - probably a number of his fellow Republicans - may think he is swimming against the tide of other Southern states, his rejoinder is that he was fortunate to have a legal option to avoid a political fight, and he took it.

Thousands of Mississippians will be grateful he did.