By Elana Gordon
http://stream.publicbroadcasting.net/production/mp3/kcur/local-kcur-982416.mp3
KANSAS CITY, Mo. – A Missouri Senate committee tasked with drafting recommendations for a state health exchange held the first of at least three statewide hearings in Kansas City yesterday. Exchanges are new organizations under the federal health law, intended to provide a more organized and competitive marketplace for buying health insurance. But as KCUR's Elana Gordon reports, yesterday's hearing wrestled with the very notion of developing one in Missouri.
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The eight-member committee focused the majority of the nearly four and a half hour, packed hearing, on asking the state's insurance director and attorney general about the legalities of an exchange, what kind of role the federal government would have in one, what exchange efforts are already underway in the state, and how a state-run or federally-run exchange would actually work.
"Is it better to have a state exchange, or let the federal government come in?" committee member Robert Schaaf, who opposes the federal health law, asked during the hearing.
The federal health law requires states to set up an exchange by 2014. Otherwise, the federal government will step in and run one instead.
Senate committee member Jane Cunningham worried that creating a state-run exchange would weaken Missouri's and other state's legal challenges to the federal health law - and its requirement that people buy health insurance.
Attorney General Chris Koster, who filed a legal brief with Florida's lawsuit, responded, "I don't think that however the legislature decides to move will affect the outcome of the case."
Koster also said as long as a state exchange does not require people to buy coverage in it, then it doesn't appear to be in violation of proposition C, the voter-approved legislation prohibiting insurance mandates in Missouri.
With multi-state health care lawsuits currently tied up in court, Koster said he'll have a better understanding by this fall of whether and when the Supreme Court might take them up.
The committee spent the biggest chunk of time hearing from John Huff, Missouri's insurance director. Huff said a state-run exchange would make coverage more affordable for Missourians by enabling "apples-to-apples" comparisons of health plans.
Mark Sergener, an insurance agent from St. Joseph, was one of several people who testified against the creation of an exchange. Sergerner said he was concerned about how an exchange would affect insurance carriers and coverage options in the state.
"I'm afraid that health care reform, or the federal plan, will simply weaken a very strong distribution [of insurance companies and policy options] already in existence in Missouri."
At least two others hearings are scheduled next month for Columbia and Jefferson City. The committee plans to have their exchange recommendations ready for the 2012 legislative session.
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