The law dictates that states must “assign a rating to each qualified health plan offered through such Exchange in accordance with the criteria developed by the Secretary” and “utilize a standardized format for presenting health benefits plan options in the Exchange.” The law also specifies that health plans must disclose certain information in plain language. Who determines what constitutes plain language? Well: “The Secretary and the Secretary of Labor shall jointly develop and issue guidance on best practices of plain language writing.” Then, there’s this dandy: “An Exchange may not establish rules that conflict with or prevent the application of regulations promulgated by the Secretary under this subtitle.”
Given that governors will have no real control over the exchanges anyway, they may as well let Obama administration officials sleep in the bed they made for themselves. It’s highly doubtful that the same administration responsible for implementing the failed economic stimulus package will be able to competently operate dozens of exchanges. Republican governors should allow the feds to live with the mess they created rather than clean up for them.
Another reason Republican governors should hold off on setting up exchanges is that there’s still a pending lawsuit that could drastically affect their implementation decision.