As you may know, there's a debate in the Rhode Island Statehouse over how to fund the state's online health insurance marketplace, HealthSource RI, after the Obamacare money runs out. Some say the $17 - $23 million dollar price tag to fund the site, customer service reps and centers, and infrastructure needed to negotiate for health insurance plans for sale on the site is just too much for a state with anemic coffers. Others say we can find a way to keep it going, and that the benefits of running our own state-based exchange outweigh the costs.
Who's weighing in
I take no position either way, of course. But I'd like to let you know more about who has, in addition to Rhode Island lawmakers and other stakeholders. The Florida-based Foundation for Government Accountability dispatched one of its senior fellows, Josh Archambault, to testify against HealthSource RI and advocate for defaulting to the federal exchange. Archambault recently penned this piece in Forbes.com about us, and laid out a case for dismantling other state-based exchanges. They don't add value, he says, they're expanding Medicaid past the breaking point, and voters won't support higher taxes to pay for them.
FGA is a conservative think tank, helmed by former Maine lawmaker Tarren Bragdon, focused on limited government and free enterprise. The group is known for supporting a Florida attempt to drug-test welfare recipients, but a judge wasn't so sure they knew what they were talking about. He threw out a report the group submitted as evidence saying it was not "competent" expert opinion.
The FGA is engaged in a broader campaign against Obamacare in general in other states. For example, it orchestrated this push in Alaska to convince people not to enroll in Obamacare insurance plans. The group also backs this site, "Uncover Obamacare," a blog about the "risks to your health and finances of enrolling in the ObamaCare exchange."
There's nothing wrong with espousing a particular political view, but I think it's fair to ask whether an outside group's views take into account the particulars of Rhode Islanders' wants and needs.
Of course, plenty of Rhode Islanders are weighing in on the debate. Here's a good rundown of the arguments made for and against keeping the exchange at a recent House finance committee hearing.
More expert sources
Here's where I'm turning for more unbiased information about Obamacare exchanges in general:
- The Urban Institute's Health Policy Center. The institute was chartered by President Johnson in the 1960s. And yep, it's a bit wonky. But what you'll find here is independent research tracking how states are rolling out Obamacare, insights into public opinion, and evidence-based analysis of what's working, what's not, and what's likely to happen going forward. Widens the conversation beyond "who's paying for it" to "how is this affecting everyday Americans?"
- The Kaiser Family Foundation. Top notch independent, non-partisan information about national health topics. Here's a recent brief, for example, on how competitive - or not - some state-based exchanges are, compared to the private health insurance market before the implementation of Obamacare. That was part of the plan: to encourage more competition in the health insurance market and, presumably, pass on any savings to consumers. Whether or not that's happening yet is an open question.
- I also follow Georgetown University's Center on Health Insurance Reforms blog. There's lots of expert analysis of state-based exchanges and the roll out of the Affordable Care Act in general.
I'll keep my eye on the debate over HealthSource RI and keep you posted.