To bring New York into compliance with the Affordable Care Act, Governor Andrew Cuomo had to create the new exchange in his state through executive order. From the New York Times:
Gov. Andrew M. Cuomo, stepping into the national debate over President Obama’s health care law, used his executive power on Thursday to carry out one of its critical features in New York after the state’s Republican lawmakers blocked legislation to do so.
[...]
For nearly a year, Mr. Cuomo asked the Legislature to set up the exchange. But the Republican majority in the State Senate refused to consider the measure, arguing that approving the exchange would amount to condoning the law, the Affordable Care Act, which they deride as Obamacare.
This incident does highlight an often underreported issue regarding President Obama’s signature health care law, the implementation has turned into a real mess. Given the nearly united Republican opposition to the law relatively few state legislatures have taken all the steps necessary to have a fully functioning system set up by 2014. Even in a very blue state like New York, the legislature is not taking the steps it should.
This whole problem could have been avoided if Democrats had gone with a national exchange like in the original House bill; but instead, Democrats foolishly insisted on going with the Senate’s idiotic approach of using a state-based exchange. It is likely that several states will not be ready to implement the law in 2014 forcing the federal government to step in to try to fill the voids.
A word of advice to future politicians. If you actually want your signature initiative to succeed don’t make people who hate the initiative and want it to fail responsible for making sure it is successfully implemented. That is political and policy malpractice.




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I’m trying to find a bright side to ACA’s Exchange rules – perhaps having State Exchanges makes it easier for states like Vermont to ask that the Exchange insurance premium subsidy monies be paid directly to the state to help subsidize state single payer universal health?
I know it is just accounting and nothing real happens – a National Exchange could do the same waiver for the same amount of money – but I am just trying to find something in ACA that is not just a cover for a $600 billion welfare check to the insurance companies on which they will take down their overhead before pretending to offer policies that are of value to the non-upper middle-class.
I posted in my diary on the ACA/Medicare push for changing fee for service into Accountable care funding http://my.firedoglake.com/papau/2012/04/12/obamains-cos-push-accountable-care-as-cost-control-in-lieu-of-single-payer-with-budget-despite-cbo-report/ – seems CBO found zero Cost savings in the change to Accountable care, but I expect the 2012 Obama crowd to try to sell it as one of their health care cost savings that made single payer with budget and cost controls board unnecessary.
Nobody could have predicted.
Republicans do stuff. Really awful stuff, for the most part, but they do it. Today’s Democrats spend their time setting up a framework to adjust marginal tax rates to provide incentives for voluntary initatives by the private sector to …
If youn think Prince Andrew is a Democrat, you don’t live in NY.
Your right, we know him but at least its something. Maybe it will help with with those high insurance costs.
I believe the Obama Misadministration actively wants this policy to fail and deliberately packed it with so many gifts to Big Pharma and the Republicans to ensure killing it is a cake walk for them. Not because he intends to expand Medicare to single-payer/public option levels. Quite the opposite: he and the rest of the Democrats intended to tell the voters once again, “Ho hum, we tried. But those bad ol’ Republicans … *sigh* … Please, feel sorry for us, keep holding your nose, and keep rewarding our passive-aggressive penchant for failure for the next 40 years. On command. Or else we’ll keep siccin’ those Republican lunatics on you by deliberately losing elections through carefully calibrated retreat and surrender. Hell, it’s not like we’re gonna suffer – we’re millionaires, and you’re not! And you won’t get mad enough to pound the streets with your feet and start voting with bullets and instead ballots, either – we helped distract and dumb you down that much! Besides, we got drones and nukes, biotch!”
Because it has kept generating results for them since 1980.
They’re not about to change what works for them …
Here in Minnesota we have one of the better State healthcare systems (MNcare) which I think former republican Governor Arne Carlson created. There was a recent MPR show discussing the set up of exchanges and other requirements of the ACA. Governor Dayton’s team members on the show were quite open that it may be impossible to meet the deadline even with MN already being way ahead of almost all other states. They had no idea what many other states were going to do being that some hadn’t even started. The logistics of setting up the exchange seem to be an incredibly difficult task according to the panelists.