Emails show that South Carolina Governor Nikki Haley wanted a state panel to opt out of the health care reform law’s requirements– even though that committee received a $1 million grant so it could study ways to move South Carolina into compliance with the law.
The Charleston Post & Courier reports emails they requested under the Freedom of Information Act show Haley’s staff pushed the Health Planning Committee not to set up a statewide health insurance exchange. The emails indicate that the staff was concerned about the response from conservatives and Tea Party supporters who strongly oppose the health care law.
Some proponents of the law are now concerned the committee was just public theatrics, while officials actually intended to opt out the entire time. “If in fact it was predetermined what the report was going to say… I think it was wasting peoples’ time,” Sue Berkowitz, a consumer advocate who worked with a subcommittee below the main panel, told South Carolina Radio Network.
The exchanges are online marketplaces each state is responsible for setting up, where the uninsured can compare plans from different companies and buy the one that best fits their needs. It was the cornerstone of President Obama’s reform bill passed in 2009.
The Health Planning Committee was created by Haley’s executive order in March. After more than 30 meetings, it turned in a report last month recommending that the state allow the federal government to operate the health exchanges once they become mandatory in 2014.
An audit of the $1 million grant in October found the South Carolina Department of Insurance had spent roughly $282,000 combined on both a University of South Carolina study and the program director’s salary.
Haley’s spokesman said the governor wanted to save the state money by having the federal government run the exchanges instead. South Carolina is hardly alone in rejecting a state-run exchange. Only 13 states have passed legislation creating them, while most of the 26 states suing to stop the Affordable Care Act have either returned the grant money, or plan on having the federal government assume the costs of the exchange.
The emails indicated that state Department of Health and Human Services director Tony Keck was originally open to discussion on the exchanges. In one email thread, he suggested writing an op-ed column highlighting some conservative principles in the idea and that “exchanges are viewed by Democrats and Republicans as an important component in improving health care outcomes and lowering costs.”
Haley’s chief of staff Tim Pearson shot down that idea, “I don’t want the Administration to embrace the idea of an exchange as conservative,” he in a follow-up email, “It’s a very tough slog to try and change the perception on that.”
Keck defended the final decision, “Anyone who sat in the all the committee and subcommittee meetings, read all the materials and knows the forty or so participants understands that there was no predetermined solution,” he said in a statement, “Everyone had starting opinions and final opinions and the recommendation that won approval was to not pursue a government operated exchange.”
Several members of the panel said they were not pressured to opt out of the law, “Different people have different conclusions about what should be done,” said Mike Vasovski–a general practitioner who represents health providers on the committee. “There was no presumption of this thing going one way or the other. At least it wasn’t directed to me that way.”
When he was contacted by South Carolina Radio Network, Vasovski said he had not seen the Post & Courier report. However, he disputed the idea that the committee had wasted time and money, saying their final report included much more than the exchanges. “Everything from our consumer-driven aspect was to look at ways to increase competition,” Vasovski said, “That’s the only way to get healthcare expenses down.”
Berkowitz said she would be disappointed if it turns out the committee members had decided not to pursue the exchanges long before they even met, “What it does is it sets the tone for people in the future to say, ‘well, why should I participate if it’s already been decided what’s going to be done?'”