The federal government granted Nebraska more time Friday to develop its own health insurance program, though one key lawmaker said officials have dawdled for so long that a federal takeover may be the state's best option.
LINCOLN, Neb. (AP) - The U.S. Department of Health and Human Services is allowing Nebraska and other states until Dec. 14 to submit their plans for a health care exchange as part of President Barack Obama's health care law. The exchanges are intended to enable residents to easily shop for insurance.
Some states had complained that the original Nov. 16 deadline didn't give them enough time to design a plan, because many were waiting for the outcome of the presidential election. But all states are still required to declare by next Friday whether they will create their own exchange or allow the federal government to do so.
Sen. Jeremy Nordquist, an Omaha Democrat, said Gov. Dave Heineman's administration has released few details about what the state will propose, even though tens of thousands of Nebraska residents will likely use the exchange. Heineman, a Republican, has said the law is unaffordable and unsustainable.
Nordquist said Heineman should use the new deadline to allow his plan to be subjected public scrutiny.
"This just pushes the decision back," Nordquist said Friday. "Now there are no excuses for us not to engage the public about his plan."
The new federal law requires states to submit a plan for a consumer-friendly marketplace for health insurance. The exchanges will allow users to buy insurance online, over the phone or through an agent, and will help determine whether consumers qualify for subsidies based on their income.
Under the law, states have three options: create their own program, enroll in a regional one or allow the federal government to run a program for them. States that don't act will default to the federal program.
Nordquist acknowledged that states have "a couple weeks of wiggle room" to submit a blueprint, but the health care law also includes a hard Jan. 1 deadline for the federal government to certify each state's program. Beyond that, states have one year to activate their program, test it, and make sure all the right software and connections are in place.
The governor's resistance to the law makes Nordquist question whether Nebraska will be ready in time. Nordquist has floated two bills in the last two years to start a discussion about how Nebraska should proceed, but both died in committee.
Now, he's not sure whether the state should create its own or adopt a federal plan.
"I started out as a strong proponent of state-based exchanges, to keep the decisions local," Nordquist said. "But at this point, it's almost like, 'How can we get this done?' It's not the federal deadlines that are the problem. This is the position we've put ourselves in."
Heineman said earlier this week that the federal government still has not given Nebraska all the information it needs to decide which approach is best.
Heineman had previously said the state needed to wait until the U.S. Supreme Court ruled on the law. When the court deemed most of the law constitutional in June, Heineman said the law's future was still uncertain because of the presidential election. Republican Mitt Romney had promised to repeal the law if elected, but his loss essentially guarantees that the law is here to stay.
A Heineman spokeswoman said Friday that the governor's schedule didn't allow him time for an interview.
During a post-election press conference on Wednesday, Heineman said the federal government still hadn't given the state specific regulations needed to decide whether a state or federal approach is best.
"It was clear to me for the last month at the federal level that they were not talking about Obamacare, and they were not doing anything about Obamacare until after the election," Heineman said. "Well, the election's over. So let's hope the federal bureaucracy starts answering our questions - and quickly."
At least 17 states and the District of Columbia are on track to set up their own exchanges, while 10 have decided against it. Representatives from Nebraska's insurance and hospital industries have said they would prefer a state-run program, as have advocates for low-income and rural residents.
Fabien Levy, a spokesman for the U.S. Department of Health and Human Services in Washington, said the department is willing to work with states and provide "significant flexibility" to help them establish their programs.
"Most states will take an active role operating their exchange, and we will work with any state to set up an exchange at any time," Levy said in a statement. "Consumers in all 50 states will have access to an exchange come January of 2014."
In an open letter to Heineman last week, Nordquist said the election has eliminated "any justifiable excuses" to delay enacting the law.
Associated Press writer David Pitt contributed to this report from Des Moines.
(Copyright 2012 by The Associated Press. All Rights Reserved.)
(Image courtesy of Stock.xchng)