By Casey Seiler
ALBANY — Sidestepping opposition from Republicans, Gov. Andrew Cuomo on Thursday issued an executive order creating a state health exchange to help small businesses and individuals secure medical insurance in accordance with the federal Affordable Care Act.
Once it’s up and running, the exchange will essentially function as the health insurance equivalent of such best-deal clearinghouses as the travel website Expedia. The owner of a small business, for example, would be able to determine the best package from a slate of options custom-fitted to its size and needs.
Cuomo’s action provides the basic scaffolding for the exchange, which will develop under the aegis of the state Department of Health in consultation with the Department of Financial Services and other agencies. While the order sets no deadline for the exchange to be operational, it’s anticipated to be ready for business sometime in 2013.
The exchange, the administration said, will be “entirely financed by the federal government.”
The administration pitched the benefits not only for those who will seek insurance through the exchange, but also for the state and local governments that pay more than $600 million annually to cover the health care costs of uninsured individuals — adding an additional $800 in premiums on a family’s average yearly cost.
“The sky-high cost of insurance in New York is driving businesses out of the state and preventing lower income New Yorkers from being able to afford needed coverage,” Cuomo said in a statement. “Establishing the health exchange will bring true competition into the health care marketplace, driving costs down across the state.”
Cuomo had discussed putting the creation of the exchange into the just-enacted state budget, but that strategy encountered resistance from the state Senate’s majority Republican conference, including members who refused to assist in the birth of an entity derided by many conservatives as a child of “Obamacare.”
Supporters, however, noted that the state’s failure to take the first steps to create an exchange capable of being operational by the start of 2014 would have resulted in the establishment of a federally run project — and the potential loss of millions in federal grants.
The state has already received almost $40 million over the past two years from federal planning and setup grants for an exchange. It has until June to apply for an even more lucrative set of second-stage grants.
The federal reform law requires that any state wanting to operate its own exchange must show by the beginning of 2013 that it will be ready to accept applications by Oct. 1, 2013, and will be operational by the start of 2014.
New York’s exchange, the administration said, will be “financially self-sustaining, requiring no state subsidy” by the beginning of 2015. Until that time, the bill will be picked up entirely by federal funds.
The order also calls for the organization of regional advisory groups consisting of stakeholders such as consumer advocates, health care providers, insurers and unions.
Advocates were almost universal in their praise for Cuomo’s action. Elisabeth Benjamin, a co-founder of Health Care for All New York, has been warning of dire consequences of delay by the state for more than a year. In one of several positive reactions included in the governor’s announcement, Benjamin praised his “leadership and determination.”
“This is our best shot for New York to begin to curb out-of-control health insurance costs,” she said, “and it will help individuals, families and small businesses who are desperate to obtain affordable and better-quality health insurance.”
Senate Republicans, who have maintained warm relations with Cuomo, greeted the executive order with almost total silence. Senate Majority Leader Dean Skelos has said in recent weeks that while he disagrees with Cuomo on the need for an exchange, he wouldn’t attempt to block the executive order through a lawsuit. On Thursday, Skelos’ spokesman declined to comment on the order.
Sen. Greg Ball, R-Putnam County, issued one of the few outright pans of Cuomo’s action, calling it “more political than reality.”
“Federal funding is not without strings and the program itself will ultimately, if enacted, cost New York taxpayers billions of additional dollars that we do not have,” Ball said.
He added that with large chunks of the federal reforms under consideration by the U.S. Supreme Court and the White House in play in November, “there is zero need to build an initial framework for a large and expensive government program that may never get off of the ground.” (ARTICLE)