Nebraska Governor Requests Public Input for State Health Insurance Exchange

Last week, Nebraska Governor Dave Heineman announced a series of public meetings that will be held over the next month regarding the state’s decision whether to and how to establish its own health insurance exchange. Under the Patient Protection and Affordable Care Act (PPACA) (P.L. 111-148), each state must have an exchange, which is an online marketplace for health insurance plans, in place and operating by January 1, 2014.  November 16, 2012 is the deadline for states to submit to the federal government their decisions whether to design their own exchanges and their plans for implementing the exchanges. If a state elects not to design its own exchange, it will be required to implement a default exchange designed by the federal government.

The eight planned meetings will be held statewide beginning August 27th and will be hosted by Governor Heineman and Bruce Ramge, the director of state insurance. Over 30 advocacy groups, health care associations, and insurance representatives have been asked to attend and speak at the meetings about the exchange option they recommend and how it should be funded. The public will be able to participate in a question-and-answer period at the end of each session with Nebraska’s exchange-planning team.

Unlike many other states, which are establishing their exchange plans through their legislatures, the governor intends to issue an executive order to submit Nebraska’s plan to the federal government. He contends that his administration is granted the authority under Nebraska’s constitution in order to protect the state’s interests. State Senator Jeremy Nordquist has indicated his support for an executive order establishing the exchange as long as the administration keeps the process transparent to the public and “…not behind closed doors by bureaucrats.” To ensure transparency, Nordquist stressed the need for a public board to govern the exchange and stated that he would propose legislation to create such a board if the governor did not create one in his plan.

Governor Heineman made it clear that these meetings will address the health insurance exchange only and not include discussion of Medicaid expansion. After the U.S. Supreme Court’s June ruling that states are not obligated to expand their Medicaid programs under PPACA, the governor has indicated that Nebraska will opt out of expansion because it cannot afford to add to the program’s rolls.