BISMARCK, N.D. (AP) — North Dakota's House Republican majority leader says the Legislature may revisit whether the state should take part in running a new health insurance marketplace that is a key part of the new federal health care law.
Lawmakers rebuffed a proposal for a state-run "health exchange" a year ago, when many Republicans hoped the U.S. Supreme Court would throw out the law — or that this year's elections would lend momentum to efforts to repeal it.
Neither happened, and lawmakers may have to rethink their next moves, said Rep. Al Carlson, R-Fargo, the majority leader.
"I don't think there's any question we have to analyze what our options are," Carlson said. "Now, I don't see any hope of (the federal health care law) being changed in Congress."
States must notify the federal government by Friday whether they intend to run their own insurance exchanges. Gov. Jack Dalrymple said the state planned to inform the Department of Health and Human Services that "we're not planning on moving forward."
"We might continue to look at ... other possibilities, such as a partnership deal," the governor said. "I think it's fair to say the law will not be repealed, and I think it's fair to say the implementation of it is going to go forward."
The exchanges are meant to make it simpler for customers to shop for health insurance by offering standard packages of benefits. Buyers may also be eligible for federal subsidies to reduce the cost of getting coverage.
The health care law gives states the option of administering their own exchanges or ceding the task to the federal government. North Dakota lawmakers, during a special session last year, opted to let the federal government do the job, in part because they were skeptical of how much autonomy state administration would provide.
Carlson said that stance could be reconsidered. One option, he said, would be to explore what the federal Department of Health and Human Services calls a "state partnership exchange," which would allow some state management of the system.
"If we're forced to have something, I would think we would look at state exchange (administration), instead of the federal side," he said.
Dalrymple said the partnership option could be acceptable, but he wants more information about how it would work. Kathleen Sebelius, secretary of the federal Department of Health and Human Services, said in a letter to governors last week that states have until Feb. 15 to choose that option.
Sen. Tim Mathern, D-Fargo, an advocate of the federal health care law, said the GOP-controlled Legislature "gave away all of its options" in an unsuccessful gamble that the law would be overhauled or junked.
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