Virginia Gov. Bob McDonnell issued a scathing rebuke of how President Obama's staff has handled its own health care law, accusing the administration of dragging its feet and preventing states from preparing to comply with the overhaul.
McDonnell forwarded new findings to the General Assembly late last week from the Virginia Health Reform Initiative Advisory Council, including a recommendation that Virginia set up its own health insurance exchange instead of joining a federal exchange. The exchanges, a vital component of Obama's new law, allow uninsured individuals and small businesses to buy health care coverage from competing insurance companies and must be operational in states by 2014.
But in a letter proceeding the report, McDonnell, a Republican, told lawmakers the Obama administration has missed deadlines for producing an outline of what the federal exchange would look like, leaving states at a loss for how to proceed with important deadlines fast approaching.
"Without the necessary guidance and rules that will govern a Virginia exchange and a federal model to review, it is extremely difficult to evaluate whether ceding control of an exchange to the federal government or creating our own is in the Commonwealth's best interest," McDonnell wrote. Still, Virginia is likely to follow other states and set up it's own exchange, conceded Keith Hare, deputy secretary for the Virginia Department of Health and Human Resources.
The report also recommended the exchange fall under a quasigovernmental body instead of an existing agency. Virginia has until June 2012 to decide how to proceed if officials want to qualify for a federal grant to pay for the setup of an exchange.
The exchanges will assist about 100,000 Virginians find private insurance, the report estimated. Another 420,000 uninsured individuals would gain coverage through expanded eligibility in Medicaid programs required by the new law. Federal aid will help pay for the initial surge in Medicaid enrollment but that assistance will dwindle over time.
Of course, the work to build an exchange all could be for naught if the U.S. Supreme Court rules next year the health care law is unconstitutional. Virginia is awaiting action from the high court on its lawsuit against the administration over the law.
"While uncertainty looms over its constitutionality, each day that these cases remain unresolved means that states must spend more time and money to prepare for the expensive and burdensome requirements of the health care law," McDonnell said.