LINCOLN, Neb. (AP) — Unanswered questions about the new national health care law have slowed Nebraska's efforts to prepare a statewide insurance exchange, state insurance officials said Monday.
Nebraska insurance analysts told a legislative panel that they need more federal guidance before deciding which health exchange option to recommend, so the state can comply with the Obama administration's overhaul of the nation's health care system.
The state exchanges are meant to offer a one-stop-shop for Americans to buy health insurance coverage. The state exchanges must be federally certified by January 2013 and operational by the start of 2014.
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State officials must decide whether Nebraska will join the federal exchange, participate in a regional exchange with other states, or launch an exchange of its own to comply with federal law. Sciullo said a regional exchange appears unlikely, because each state has different regulations and needs.
State health insurance analyst Michael Sciullo said officials still haven't learned the exact details of the health insurance exchange offered by the federal government. Still unclear is whether a Nebraska-run program would carry over to other states, which option is the most cost-effective and how many participants would meet various income requirements to enter into an exchange.
"There seems to be a lot of challenges with the concept," Sciullo said. "I think initially it was a concept that sounded great, particularly when we talk about the pooling aspect. But with all the other challenges facing states as they prepare for the exchange process … it's been one of those things that sounded a lot better in theory than has worked out practically."
The state insurance officials gave their briefing to a joint meeting of the Legislature's Banking, Commerce and Insurance Committee and Health and Human Services Committees. The health care exchanges are expected to surface as a significant issue when lawmakers convene a new session in January.
A state-commissioned study released last August determined that the new federal law will increase Nebraska's Medicaid costs by $526 million to $766 million over the next decade. In May, a state-by-state report commissioned by the Kaiser Commission on Medicaid and the Uninsured estimated a much lower cost of between $106 million and $155 million.
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