NRS 695 i (The Silver State Health Exchange means federal Patient Protection and Affordable Care Act, Public Law 111-148 "Obamacare".) "Perform all duties that are required of the Exchange to implement the requirements of the Federal Act." NRS 695i.200(e) Healthcare Exchanges are insurance marketplaces.
Questions and Answers about state health exchanges/Obamacare
3. What is Nevada's exchange called and what does the law say?
The State Insurance Exchanges or marketplaces, while not mandatory, are one of most vital aspects of ObamaCare. States can implement a state run health insurance exchange, or refuse to establish a state-based exchange, defaulting to a federally-facilitated marketplace. Either way, all exchanges are required to contract only with health plans that meet federal requirements. State insurance exchanges set up a massive, federally-dictated, essentially government managed conduit. President Obama and Harry Reid prefer these state exchanges – really de facto federal exchanges in disguise ― because the Federal government doesn’t have to set them up, states exchanges have to comply with Obamacare and its federal rules, and these exchanges are often established by Obamacare opponents. The success of the state run health insurance exchanges are a barometer for measuring the success of Obamacare.
Big Government Obamacare lobbyists for state exchanges told state legislators that if their states did not create their own exchange, the federal government will control Obamacare in their state through a federal exchange. The federal government also provided taxpayer funded incentives to create the exchanges. HHS Secretary Kathleen Sebelius extolled the “flexibility” that Obamacare allows state exchanges. But, what we know now is that state exchanges are ‘a federal exchange with a veneer of state flexibility.’
Any exchange created under the current rules is fundamentally flawed, anti-market and anti-consumer, setting the stage for never-ending bureaucratic regulation. The reality is states can only impose harsher regulations than Obamacare requires. State-run exchanges can’t prevent the most affordable plans from disappearing because of Obamacare “essential” coverage mandates or keep comprehensive health plans from crumbling under the weight of price controls or cover the sickest patients struggling to get their claims paid by insurers who are trying to avoid, mistreat, and dump them. The exchanges are an administrative nightmare that virtually ensures gaps in coverage for millions of Americans and additional costs for states. Taxpayers under Obamacare state exchanges, like Nevada’s, will pay for their own state exchange and in addition will pay billions of dollars for other states opting out of state exchanges.
It’s not just coincidence that Florida Gov. Rick Scott, a former health care executive and Louisiana Gov. Bobby Jindal, a former top official in the U.S. Department of Health and Human Services (HHS) refuse to set up an exchange. Governor Scott Walker of Wisconsin denounces the state exchanges as “SINO” or “state in name only.” State policymakers are kidding themselves if they believe developing an exchange will protect them from federal government interference and inevitable future premium hikes under Obamacare. The reality is that control over the exchanges will reside in Washington not in the states.
There is no justification for - or advantage to - having a state exchange. The consequences for creating state exchanges and conspiring with Federal Obamacare could be profoundly negative but there are few consequences for resistance or opting out. Bottom line, it’s up to us, We the People.
The Congressional Budget Office (CBO) found repealing state exchanges would have the net effect on the federal budget of a savings of over $15 billion over ten years. John Graham, when he was with the Pacific Legal Institute, wrote, “States establishing Obamacare exchanges are making a one-way, lose-lose bet.