“If there’s to be a train wreck, we governors would rather be spectators than conductors,” Daniels wrote. “But if the federal government is willing to reroute the train to a different, more productive track, we are here to help.”
In the letter, the governors asked HHS to provide states with “complete flexibility” on operating the exchange, including the choice of which insurers can offer products; waive mandates and allow states to choose benefit rules; waive provisions discriminating against consumer-driven health plans, such as health savings accounts; allow the flexibility to move non-disabled Medicaid beneficiaries into exchanges; deliver a plan for verifying incomes and subsidy amounts for exchange participants; and commission a “new and objective" assessment of how many people will enroll in exchanges and Medicaid as a result of the reform.
The letter was essentially a rebuke of what the governors described as federal overreach.
“We wish states had been given more opportunity to provide input when the [law] was being drafted,” the governors wrote. “We believe in its current form the law will force our health care system down a path sure to lead to higher costs and the disruption or discontinuation of millions of Americans’ insurance plans.”
HHS must certify state exchange plans by Jan. 1, 2013, and they must be operational by the following year.