Christie: Nope, we won’t be building a state exchange in New Jersey

posted at 4:31 pm on December 6, 2012 by Mary Katharine Ham

Oh, the fall from Beltway media grace shall be sharp and swift for the country’s most popular Republican.

Christie’s decision comes in ahead of the Health and Human Services already postponed deadline of Dec. 14. It also comes on the same day Christie is meeting with President Obama about aid for Hurricane Sandy recovery. Would that be the opposite of a hug? The governor today vetoed state-exchange legislation from his state assembly— a revised version of bill he vetoed in May— and says it comes down to insufficient information from the federal government on what building an exchange will entail. From his statement:

“Such an important decision as how to best move forward for New Jerseyans can only be understood and reasonably made when fairly and fully compared to the overall value of the other options. Until the federal government gives us all the necessary information, any other action than this would be fiscally irresponsible. Thus far, we lack such critical information from the federal government. I will not ask New Jerseyans to commit today to a state-based exchange when the federal government cannot tell us what it will cost, how that cost compares to other options, and how much control they will give the states over this option that comes at the cost of our state’s taxpayers.”

“Financing the building and implementation of a state-based exchange would be an extraordinarily costly endeavor,” continued Governor Christie. “While the federal governmental has enabled states to apply for grant funding to cover some of the initial costs of such an endeavor, the total price for such a program has never been quantified, and is likely to be onerous. Without knowing the full scope of which exchange option would be most beneficial and cost efficient for New Jerseyans, it would be irresponsible to force such a bill on our citizens.”

Remember, the Obama administration just put forth a regulation explaining what elements must be in exchange insurance plans the week of Thanksgiving— 32 months after the bill passed and just 11 months before open enrollment is due to start in exchanges. The Affordable Care Act gave states the option to build exchanges on their own, partner with the federal government to build them, or hand over the building of the exchange to the federal government entirely.

There are now at least 19 states that have declined to build exchanges of their own, which means an ever-growing technical heavy lift for Sec. Kathleen Sebelius’ troops. They didn’t anticipate having to build so many— the New York Times reported the administration assumed foolishly every state would simply build their own— and are apparently far from ready to debut one.

Christie did not close the door on some day starting an exchange once the state has more information from the federal government, but he’s not going to be among the first down this path. New Jersey Democrats who helped author the bill had urged Christie to build an exchange and he was seen as one of the more likely prospects among Republican governors to do so. I’m not surprised he’s declining. From both a political and practical standpoint, it does not make sense to take on this bear with little idea how much it will cost, what would constitute success, or whether a completed project will actually have a federal data hub to plug into. That has not yet been built, nor is there any hint what a federal exchange might look like.

Maryland is the state perhaps best positioned to accomplish standing an exchange up by October 2013. It probably has more health care regulators per capita than any other state and has a long history of heavily regulating the industry. Its Gov. Martin O’Malley, a Democrat with national ambitions, was eager to lead the way in exchange building and the legislature has passed two rounds of legislation enabling it. But even Maryland is facing a serious time crunch, hoping to have development of its technological component finished in the second quarter of 2013. That gives it five months to make that technology work with the existing technologies, employees, and customers of all the state’s agencies and insurance carriers. And, this is a state that started preparing to launch a state exchange pretty much the day the bill passed. It’s no wonder Christie doesn’t want to take it on with far less time, just as little detail, and 50 percent more in population.

If I were a governor, my statement might be something along the lines of, “Show me yours and I’ll show you mine.”


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