As Stephanie Kennan of our affiliated company, McGuireWoods Consulting, reports in Weekly Washington Healthcare Update, several states have passed ballot initiatives concerning Obamacare health benefits exchanges, while other states had failed initiatives. A brief overview of these state measures is as follows:

  • In Alabama, in what is considered a largely symbolic gesture, voters approved an initiative prohibiting individuals and businesses from being compelled to participate in any health care system.
  • Votes in Florida rejected a proposal that would have banned government mandates for obtaining insurance, as required by the Affordable Care Act.
  • The governors of Kansas and Virginia have announced they would not pursue a state-based exchange, which means the federal government would run their state’s exchanges.
  • In Missouri, an initiative passed that prevents the governor or state agency from setting up such an exchange without legislative or voter approval.
  • In New Mexico, the state’s planning group is looking to piggyback an exchange on an existing state health insurance program launched almost two decades ago. A legislative workgroup has been studying whether this exchange — called the Health Insurance Alliance — would satisfy exchange governance requirements.
  • Vermont has issued a request for proposal for health plans and stand-alone dental plans to sell on the state’s exchange. The exchange is aiming to make final plan selections by mid-July.
  • In another gesture considered largely symbolic, voters in Wyoming passed to amend the state constitution to declare its citizens have the right to make their own health care decisions and allow the state to act to "preserve these rights from undue government influence."

States were facing a November 16 deadline from the Department of Health and Human Services (HHS) to indicate whether they planned to set up a state-based health benefits exchange in time for initial HHS approval by January 1, 2013, but HHS has extended the deadline to submit a blueprint and a declaration letter to establish a state-based exchange to December 14, according to Healthcare IT News and a Nov. 9 letter from HHS Secretary Kathleen Sebelius to state governors.