In Rick Perry's Texas, nearly 1 in 3 working-age residents has no health insurance, so there's a price to pay for his pride and politics.
Count the millions of federal dollars being left on the table, because the governor refuses to begin work on a healthcare exchange. As important, count the opportunity costs -- the missed chances to create a better health insurance market for millions of Texans who need individual and small-company plans.
A frequent criticism of the 2010 healthcare law is that it forces a cookie-cutter solution on all. Not so with health exchanges, the online shopping sites envisioned as a Travelocity for health insurance.
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Even conservative stalwarts like Mississippi and Utah have already taken steps to avoid the federal option.
While Perry complains about being fed-up with Washington, others are seizing the moment and the money. Thirteen states have established exchanges, tackling issues such as the makeup of governing boards, mandated benefits and which insurers to allow into the mix.
Twenty-eight states and the District of Columbia have received first-level grants to establish their programs. Federal payouts include $1.6 million to Tennessee, $21 million to Missouri and $39 million to California.
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But even if the law were overturned, shouldn't Texas be working on its own exchange? And on the feds' nickel?
This is different from many health law requirements. Most conservatives oppose the large expansion of Medicaid, the federal mandate to buy coverage and the premium rebates that insurers must pay if they spend too much on overhead.
But exchanges are a bet on free markets, rather than regulators. As tools, they can let consumers and insurers determine much of what happens in the marketplace.
Texas has been an innovator in electric deregulation, and its power-to-choose website has revolutionized the way people buy electricity here. They can easily compare plans, prices, complaint records and the share of power that comes from renewable energy. Retailers tout their service and inducements like frequent-flier miles.
If not for the politics, Texas could be a leader in developing a similar system for health insurance. In the 1990s, it created an insurance exchange for small businesses. That failed, because insurers outside the exchange offered lower-price coverage to healthy customers; in effect, that confirmed the problems of so-called adverse selection.
http://www.star-telegram.com/2012/02/18/3744532/perrys-texas-is-lagging-on-health.html
Hat tip: Fort Worth Star-Telegram
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