As we know, one of the provisions of the Affordable Care Act is the creation of health insurance exchanges for those who are currently uninsured and need assistance in getting it. The states are supposed to operate these exchanges, and that means some kind of action needs to be taken to get it up and running. In particular, some entity needs to be responsible for it. State Rep. John Zerwas, the chair of the House Select Committee on Federal Legislation, thinks that a new agency may need to be created for this purpose.
Zerwas, of Richmond, said he was not sure yet if the new entity would be a commission or an independent agency or something else.
But he said he does believe an organization other than the state Department of Insurance or the Health and Human Services Commission will be needed because neither agency has the capacity to take on the task.
Because of so many unknowns, Zerwas was unable to say how much money and how many people would be needed.
Zerwas added that one model could be the authority that handles a health insurance exchange in Massachusetts, the only state that currently requires residents to buy insurance.
Massachusetts Health Connector, an independent state agency that helps residents find health care coverage, opened in 2006 with $25 million in seed money appropriated by the Massachusetts Legislature. It has about 50 employees and generates its own revenue, spokesman Dick Powers said.
In Texas, legislative action would be needed to create an entity to oversee an exchange , Zerwas and other lawmakers said.
“I would be receptive to being the author,” Zerwas said.
Zerwas was an unconvincing critic of the health care legislation as it was being crafted and debated, but I have no reason to think he’d do anything but a good job figuring this out; State Rep. Garnet Coleman is also on this committee, which is an even stronger reason for optimism. I don’t have a preference at this time for how this should be approached, but with any Texas agency, the main concern is always oversight. The list of state agencies that have demonstrated that they cannot be trusted without strict supervision is a long one, and though that’s more than partially the fault of the guy who picks the heads of these agencies, this isn’t exactly a new problem. So let’s please try to get this right.