Will Lawmakers, Staff Be Exempt From Health Exchanges?

News outlets also report on whether health exchanges will end insurance monopolies; on efforts to address possible "churning" between Medicaid and the new insurance marketplaces; and the money states spent to decide against running their own exchanges.  

Politico: Lawmakers, Aides May Get Obamacare Exemption
Congressional leaders in both parties are engaged in high-level, confidential talks about exempting lawmakers and Capitol Hill aides from the insurance exchanges they are mandated to join as part of President Barack Obama's health care overhaul, sources in both parties said (Bresnahan and Sherman, 4/24).

Stateline: New Health Exchanges Unlikely To End Insurance Monopolies In The United States
In Alabama, if you get your health insurance through your employer and you lose your job, you quickly realize there aren't a lot options for purchasing coverage on your own. Blue Cross and Blue Shield of Alabama has had a virtual monopoly in the state since the Great Depression, and today it covers a whopping 89 percent of Alabamians. In part, Blue Cross and Blue Shield is dominant in Alabama simply because it has been there for so long -- it sold its first policy in 1936 -- and potential newcomers have found it difficult to convince hospitals and doctors to give them favorable prices so they can compete with the entrenched carrier. But it also has to do with Alabamians themselves: On average, residents of the state are poorer and less healthy than other Americans, making them more expensive to cover and thus less attractive customers (Vestal, 4/25).

The Lund Report: 'Churn Bill' Looks To Help People Switching From Medicaid To Cover Oregon
Next year, the Affordable Care Act will allow people whose income falls below 138 percent of the federal poverty level to receive coverage through the Oregon Health Plan. Meanwhile, people who earn up to 400 percent of the poverty line will be eligible for federal tax subsidies to help purchase private health insurance on the exchange, Cover Oregon, unless, that is, their employer decides to pay for the coverage. Realizing that incomes fluctuate, the Oregon Health Authority estimates that up to 60,000 Oregonians will "churn" between Medicaid and Cover Oregon each year (Gray, 4/24).

Kaiser Health News: Capsules: States Spend $28M, Then Leave Exchanges To The Feds
Late last year, Arizona Gov. Jan Brewer announced that her state would not build its own online insurance marketplace, a pillar of the Affordable Care Act, because there were too many unknowns. What Brewer didn't say was that her state had spent $9 million in federal money to reach that conclusion. Arizona was one of 10 states that received federal grants over the past two years to help establish a state exchange only to decide later to let the federal government handle it (Galewitz, 4/24).

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