Sentences to Ponder

And then shake your head and ponder again. This is from Politico:

While sorting out the policy kinks in setting up a federal exchange, HHS must tackle another problem: There is no money to pay for it. A quirk in the Affordable Care Act is that while it gives HHS the authority to create a federal exchange for states that don’t set up their own, it doesn’t actually provide any funding to do so. By contrast, the law appropriates essentially unlimited sums for helping states create their own exchanges.

The lack of funding for a federal exchange complicates what is already a difficult task. HHS will likely be operating exchanges in states like Louisiana and Florida that oppose the ACA on principle and have said they will not comply with the exchange provisions. But HHS also will likely be responsible for several other states that may want to set up exchanges, but will be unable to enact laws and set up the infrastructure under the short time frame specified by the law.

Comments (8)

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  1. Trudy says:

    I’m shaking my head and pondering.

  2. Simon says:

    How does the CBO score the phrase shall ‘use such sums as may be necessary’? That’s a blank check.

  3. Buster says:

    This does not surprise me. The legislation was thrown together in such a hurry that there are numerous flaws.

  4. KG says:

    How frustrating. Unfunded mandates are always tricky.

  5. Virginia says:

    Maybe the idea is to create a national exchange and take over control of state health insurance markets. Although, not providing funding for it seems like an oversight.

    So, maybe not. Perhaps that’s an afterthought.

  6. Linda Gorman says:

    I like the notion that all that stands between the omnipotent HHS and functioning health insurance exchanges are simple “kinks.”

  7. John R. Graham says:

    I’ve been writing about this for a while. It seems to me that this finding supports the notion that states should send back the grants that Sec. Sebelius has sent their way to establish exchanges, like Kansas gov. Borwnback recently did.

    I always realized that time was growing short for Sec. Sebelius to get moving on exchanges. However, if she doesn’t even have the money to do so, this really promises to kill Obamacare in its cradle.

    Remember, there is no mechanism for the tax credits to flow except through the exchanges. The entitlement cannot really arise in their absence.

  8. Carolyn Needham says:

    I’m also picturing a bureacratic nightmare in the state’s that will be running the exchanges but won’t be ready in time. In some it could just be a matter of months; HHS will go in and create the infrastructure, only to (hyopthetically) be gone in a few months.