Following Thursday’s landmark U.S. Supreme Court decision upholding the Affordable Care Act as constitutional– including the individual mandate that Americans must purchase health insurance or pay a tax or penalty– people are now taking a closer look at the law’s provisions.
That includes both those already in effect and those that will take effect in 2014. One example is the creation of health insurance exchanges that will bring together private health insurance companies along with a government health insurance option to compete for business among individuals and small businesses. USC political science professor Mark Tompkins, an expert on healthcare politics and policy, says South Carolina is one of a number of states that have lagged behind in creating the exchanges.
“There are about 35 states that are running behind in doing this (forming exchanges): so we can expect some tension over how quickly we can get these exchanges organized, and whether states like South Carolina step up to get their exchanges organized or whether the federal government organizes it for us.”
South Carolina officials have indicated they will not act to create the exchanges, essentially leaving it up to the U.S. Department of Health and Human Services to set them up.
The exchanges will also work to create a pool for small businesses to group together to purchase health insurance instead of individually that will provide lower costs for employers similar to the lower costs larger companies are able to secure because of the larger amount of their employees. Tompkins says the irony of these exchanges is that many of the principal critics against this provision have become proponents, and the former proponents have become today’s critics. Included in this changing of sides are President Obama and his GOP challenger Mitt Romney.
“President Obama initially thought that this process was probably not the best way to go. On the other hand, conservatives ranging from the “Wall Street Journal” to the Heritage Foundation to Mitt Romney thought that health insurance exchanges were the solution to our healthcare reform problems.”