State exchange panel considering options

A Georgia committee Tuesday discussed the pros and cons of building a health exchange, a day after new rules from the federal government loosened the deadlines that states face on creating these online insurance marketplaces.

State officials, meanwhile, said they are analyzing the federal exchange rules that were released Monday.

“We’re diving into the details [of the new rules] as we speak,’’ said Blake Fulenwider, health policy adviser for Gov. Nathan Deal, in an interview Tuesday. He said states face many unknowns in building exchanges.

“States are eager for greater guidance,’’ he added. “We are sort of in limbo at this point.’’

If the Affordable Care Act is upheld in the courts, states are required to have health insurance exchanges running in January 2014. If Georgia or any other state does not establish an exchange on its own, the law says, the federal government will run the operation in that state.

The new rules issued by the U.S. Department of Health and Human Services give states more flexibility on the timeline and construction of exchanges.

Insurance exchanges are seen as online shopping malls where individuals can compare and buy coverage. Their purpose is to boost the insurance-buying clout of individual consumers and small businesses, where insurers would compete on quality and price.

The state committee evaluating insurance exchanges, at its meeting Tuesday, heard presentations from exchange organizations in New York City and Florida.

“We’re seeking a Georgia solution, irrespective of what the Affordable Care Act says.’’ Fulenwider said after the presentations.

The Georgia committee is currently focused on creating a small business exchange, Fulenwider said. He said small business owners at a Columbus meeting expressed one overwhelming concern: how to deal with the constantly increasing cost of health insurance.

The price of coverage has typically ranked as the No. 1 problem of small businesses in surveys of such firms.

Georgia is among 26 states that have joined in a lawsuit challenging the Affordable Care Act. Deal, a staunch opponent of the law, appointed a committee to study exchanges in an effort to make coverage more accessible and available.

The committee is expected to present a report to the governor in September on whether Georgia should create its own exchange or leave the task to the federal government. If the decision is for the state to craft its own, then the committee would work on proposing a structure.

The New York City exchange, called HealthPass, is a 12-year-old nonprofit organization, with startup funding from the mayor’s office, that now provides coverage for 3,500 sole proprietorships and small businesses, covering 16,000 employees and 14,000 dependents. It’s not clear what will happen to this city exchange if New York state sets up its own mandated exchange.

Florida Health Choices’ “Marketplace,’’ meanwhile, is just getting started this year. It is similar to the exchange for small businesses that’s operating in Utah, said Rose Naff, the Florida organization’s CEO. Florida is looking at a private-sector solution, she said.

At the Georgia meeting Tuesday, committee members discussed the benefits and risks of an insurance exchange. The U.S. Supreme Court is expected to ultimately settle the constitutionality of the Affordable Care Act, and cropping up frequently in the conversation at the meeting was the possibility that the court will strike down all or part of the law.

Ryan Teague, Deal’s deputy executive counsel who is helping spearhead the state exchange effort, had a word of caution for the panel: “What we don’t want you to do is to assume that it’s going to be struck down.’’

Under the reform law, states are required to prove they are ready to run their exchanges a year before the deadline — in January 2013. But as part of the new rules, HHS announced Monday that states could receive “conditional approval’’ for their exchanges on the 2013 date if they have made significant progress.

And states that get ready later can still set up their own exchanges – as long as they give the federal government a year’s notice.

Karen Minyard, executive director of the Georgia Health Policy Center, said the new federal exchange rules gives states more wiggle room on the timeline.  The Affordable Care Act, she pointed out, did not address what would happen if a state wasn’t quite ready to operate its own exchange in January 2013.

“With this, it spells out that if you’re almost ready, they’ll give you a little leeway,’’  Minyard said.