Obamacare: In or out?


Aa right as Gov. John Kasich has been about the need to expand Ohio’s Medicaid program under Obamacare, he has been wrong in his refusal to establish a state health insurance exchange — an online marketplace that would enable individuals and small-business employers in the state to buy coverage.

Since the governor has forced the federal government to take on that responsibility, the least his administration and the General Assembly can do is not to obstruct that effort further. But a new state law may do just that.

Under the Affordable Care Act, nearly all Ohioans and other Americans who do not have insurance must arrange for coverage by the beginning of 2014 or face a financial penalty. As the President noted last week, many of the governors and state lawmakers who are opting out of creating their own exchanges have traditionally favored giving power back to the states.

A state exchange would be smaller and more accessible to Ohioans than a federally run one. Every state has the basis of an exchange in its public employees’ health-insurance plan. There is no reason for Ohio not to have its own exchange, except blind ideology.

Instead, Ohio will have “navigators” who will help consumers compare and buy coverage on the federal exchange. And it has a new state law regulating these navigators — enacted by Republicans who repeatedly say they want fewer laws and less regulation.

Insurers who operate within the health exchange are already regulated by state and federal law. In theory, it is a good idea to protect insurance consumers from unscrupulous middlemen.

But a last-minute amendment to the law that limits navigators’ functions to only what the federal government will pay for is worrisome. Some critics say that the law will not protect consumers as much as it will create havoc and undermine the exchange in Ohio.

If the governor and the legislature wanted Ohio to be untainted by a federal exchange, they should have created their own. But Mr. Kasich says he wants the state to “maintain authority over our markets.” That’s a different position. It means the state wants in, not out.

Muddying the waters with this new law does not help Ohio health insurance consumers. It only makes their lives harder.