In a move that should surprise no one, Arizona Governor Jan Brewer (R) officially wrote the U.S. Department of Health and Human Services to inform them Arizona will not set up its own health care exchange. This means the federal government will instead need to set up an exchange in the state. According to Brewer there is basically no reason for Arizona to waste the time and money setting up a exchange given the level of control the federal government would have over it. From Brewer’s office:
This has been one of the more difficult decisions of my career in public service. My opposition to the Affordable Care Act (ACA) is unwavering, as is my belief that it should be repealed and replaced with legislation that achieves its stated goals: to improve access to quality, affordable health care in this country. But I am also aware that the ACA remains the law of the land. Likewise, though I am a steady advocate of local control, I have come to the conclusion that the State of Arizona would wield little actual authority over its ‘state’ Exchange. The federal government would maintain oversight and control over virtually every aspect of our Exchange, limiting our ability to meet the unique needs of Arizonans and the Arizona insurance market.
Arizona is just the latest in a long line of states to officially decide to leave the management of their exchanges up to the federal government. Frankly, I consider this a positive development. Would anyone really want to use an exchange created and run by Brewer, an unwavering opponent to the Affordable Care Act? At least the federal exchange will be run by people who have a vested interest in trying to make them work.
When the law was being written I said basing it on a system of state-based exchanges, instead of a national exchange, was a terrible policy decision. It is at least nice that so many Republican governors have decide to help prove me right so quickly.