The White House on Monday issued a mammoth, 642-page blueprint to help states set up one-stop shopping markets, called exchanges, for millions of uninsured Americans who want to obtain health care under the 2010 Affordable Care Act. That's the landmark health-reform law that has come to be known euphemistically as ObamaCare.
In a broad sense, the report -- issued two weeks before the Supreme Court hears arguments on the law's constitutionality -- is a wake-up call for Ohio, Michigan, and 36 other states that have done little to embrace the law. Regardless how the governors of those states feel about Obama-Care, they should set aside politics and get down to the hard work of setting up health-care exchanges in their states.
States risk the health of many of their residents, as well as state control, if they want until the Supreme Court rules on the law, presumably this summer but perhaps not until after the fall election. The federal government has vowed to impose its own one-size-fits-all exchanges on states that do not pass legislation to set up their own by next Jan. 1 and have their programs up and running within a year after that.
According to the National Conference of State Legislatures, 12 states and the District of Columbia have passed legislation setting up exchanges. Nearly all are in the Northeast and the West. Several -- including Vermont, Massachusetts, Connecticut, Colorado, and California -- are known for more progressive social politics, even if they aren't all Democratic strongholds. But a few -- West Virginia, Nevada, and Utah among them -- don't fit that category.
That suggests compliance hasn't strictly followed party lines, which is good. Yet Ohio -- where between 800,000 and 1.5 million uninsured residents are expected to benefit from health reform -- has Democrat-sponsored legislation in Republican-controlled chambers that appears to be going nowhere as Gov. John Kasich's administration takes a wait-and-see attitude.
Even David Merritt, Republican presidential candidate Newt Gingrich's health-care adviser, has encouraged GOP-led states to stop being so stubborn. According to the conservative Cato Institute, Mr. Merritt likened the situation to walking onto a car lot and deciding whether you will pick your next automobile, or leave the decision up to the dealer.
We agree with the Ohio Consumers for Health Coverage and other groups that have implored Mr. Kasich to act. The General Assembly needs to have meaningful discussions about compliance while there is time to get it right. Hard decisions need to be made, such as who governs the health-care exchange and the degree to which insurance companies will be involved, either directly on a governing board or through the program's general operation.
Kasich administration officials say they need time to digest the final rules. That argument is good for only so long.
The prescription for a healthy Ohio is to to get to work on a health-care exchange, not to play a political waiting game until this summer's Supreme Court ruling or the November election.
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