In the Legislature Tuesday, the Banking, Commerce and Insurance Committee held a public hearing on competing proposals to establish a health insurance exchange.
Two different alternatives have been proposed for establishing a health insurance exchange - a kind of marketplace where consumers could shop for comparable insurance policies under the federal health care reform bill passed in 2010.
One of the main differences concerns who would govern the exchange. A proposal by Sen. Rich Pahls of Omaha would have it run by the Department of Insurance. Another by Omaha Sen. Jeremy Nordquist would have it run by an independent board with representatives of consumers and other interested groups.
But a bigger question is whether the state should act at all. Bruce Rieker of the Nebraska Hospital Association said there's a June 29 deadline to apply for a federal grant to establish the exchange worth between $61 million and $85 million.
Sen. Paul Schumacher of Columbus asked what would be wrong with waiting to see whether the U.S. Supreme Court rules the federal health care reform law unconstitutional. Rieker replied with a question about what if the court upheld the law. "Let's say they do it on June 28th. Do you think you can assemble a special session and get the application done by June 29th?" he asked. "There are some that bet, or speculate, that this deadline will be moved. Once again, that's a big if.' There are so many big ifs that we're playing chicken with."
But Director of Insurance Bruce Ramge urged lawmakers not to support either bill, saying it would be inappropriate to develop an exchange before the Supreme Court issues its ruling. "Governor Heineman has authorized me to state on his behalf that if necessary, to preserve Nebraska's opportunity to create an exchange he will issue a basic executive order to provide the necessary legal authorization as has been done in a number of other states," Ramge said.
The committee took no immediate action on either bill.