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Underwoods
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Dec 132012
 

Kevin Lamarque-Pool/Getty Images(WASHINGTON) — All of the Affordable Care Act, also known as “Obamacare,” doesn’t go into effect until 2014, but states are required to set up their own health care exchanges or leave it to the federal government to step in by next year. The deadline for the governors’ decisions is Friday.

The health insurance exchanges are one of the key stipulations of the new health care law. They reportedly will offer consumers an Internet-based marketplace for purchasing private health insurance plans.

But the president’s signature health care plan has become so fraught with politics that whether governors agreed to set up the exchanges has fallen mostly along party lines.

Such partisanship is largely symbolic because if a state opts not to set up the exchange, the Department of Health and Human Services will do it for them as part of the federal program. That would not likely be well-received by Republican governors, either, but the law forces each state’s chief executive to make a decision one way or the other.

Here’s what it looks like in all 50 states and the District of Columbia:

20 states that have opted out — N.J., S.C., La., Wis., Ohio, Maine, Ala., Alaska, Ariz., Ga., Pa., Kan., Neb., N.H., N.D., Okla., S.D., Tenn., Texas and Wyo.

Several Republican governors have said they will not set up the exchanges, including Chris Christie (N.J.), Nikki Haley (S.C.), Bobby Jindal (La.), Scott Walker (Wis.), John Kasich (Ohio), Paul LePage (Maine), Robert Bentley (Ala.), Sean Parnell (Ark.), Jan Brewer (Ariz.), Nathan Deal (Ga.), Tom Corbett (Pa.), Sam Brownback (Kan.), Dave Heineman (Neb.), John Lynch (N.H.), Jack Dalrymple (N.D.), Mary Fallin (Okla.), Dennis Daugaard (S.D.), Bill Haslam (Tenn.), Rick Perry (Texas), and Matt Mead (Wyo.).

3 States Out, But a Little More Complicated — Mont., Ind. and Mo.

The Montana outgoing and incoming governors are both Democrats, but the Republican state legislature rejected the Democratic state auditor’s request to start setting up a state exchange. So a federal exchange will be set up in Montana as well.

The Indiana outgoing and incoming governors are both Republicans and outgoing Gov. Mitch Daniels deferred the decision to governor-elect and U.S. Rep. Mike Pence, who said his preference is not to set up a state health care exchange, paving the way for the feds to come in too.

In Missouri, Gov. Jay Nixon is a Democrat, but Prop E passed on Nov. 6, which barred his administration from creating a state-based exchange without a public vote or the approval of the state legislature. After the election, he sent a letter to the Department of Health and Human Services saying he would be unable to set up a state-based exchange, meaning the federal government would have to set up its own.

One State Waiting for the White House — Utah

Utah already has a state exchange set up, a Web-based tool where small-business employees can shop and compare health insurance with contributions from their employee. In a letter Republican Gov. Gary Herbert sent to the White House Tuesday, he asked for its exchange, called Avenue H, to be approved as a state-based exchange under the Affordable Care Act as long as state officials can open it to individuals and larger businesses.

Norm Thurston, the state’s health reform implementation coordinator, says authorities there, “haven’t received an official response” from the White House, but, “we anticipate getting one soon.”

19 State-Based Exchanges – Calif., Colo., Conn., Washington, D.C., Hawaii, Idaho, Iowa, Ky., Md., Mass., Minn., Miss., Nev., N.M., N.Y., Ore., R.I., Vt. and Wash.

Six Partnerships — Ark, Del., Ill., Mich., N.C. and W.Va.

Two Undecided — Va. and Fla.

That makes 23 states that will have federal exchanges, 19 states will have state-based exchanges (including the District of Columbia), six are planning on partnership exchanges between the federal government and the state, Utah is waiting on an answer from the federal government, and two states have not officially announced their decision: Virginia and Florida.

A representative for Virginia Gov. Bob McDonnell said an official announcement is likely to come Friday, but the Republican governor has repeatedly said he will likely reject the state-based exchange, paving the way for the federal government to come in.

Florida Gov. Rick Scott indicated last month that he was considering implementing a state-based exchange. He has made no official announcement either way and the Republican governor’s office told ABC News they had no update on a decision, despite being a day away from the deadline.

Renee Landers, a professor of law at Suffolk University Law School in Boston who has written extensively on the new law, says if the remaining states don’t make an official announcement by Friday, it’s likely they will default to the federal exchange.

“If they don’t decide to do it themselves, the default is the federal government will set it up,” Landers said.

Landers boils down the decision by the nation’s governors as this:

“If you want to wash your hands of [the ACA] as much as you can, entirely a federal exchange is your choice. But if you want as much control as possible, then the state exchange is the way to go; and the partnership, well every partnership is complicated,” Landers said. “Sometimes it’s nice to have the help, but on the other hand, you don’t always get your way.”

The Five Who Broke Party Lines:

Not all of the country’s Republican governors rejected the state-based exchanges: Iowa Gov. Terry Branstad, Mississippi Gov. Phil Bryant, Idaho Governor Butch Otter, New Mexico Gov. Susana Martinez and Nevada Gov. Brian Sandoval all decided to assert more control over the plan and, despite some grumbling, will set up the state-based exchanges.

“If the state really believes in federalism and state control, then operating its own exchange is the best way,” Landers said.”Its appeal is that it relies on competition in the market for health care coverage instead of a public system.”

Landers says the new law also tells states they can form inter-state compacts and run exchanges by region, though none of the states decided to so. But “the federal government, in areas where they have contiguous states with a lot of shared markets, you can see the federal government saying, ‘We won’t have two infrastructures for those states, we will have one,’” the professor said.

One example could be New Jersey and Pennsylvania, two states that will have federal exchanges and are next to each other.

“I think it’s funny that governors who purportedly want to be in charge of their own fate don’t want to be involved [in setting up the exchanges],” Landers said.

“But then they have no responsibility for things that go wrong and there will be things that go wrong, mistakes will be made and they will have deniability.”

Copyright 2012 ABC News Radio

Dec 102012
 

ABC/Donna Svennevik(WASHINGTON) — In a letter sent to key lawmakers on Capitol Hill former U.S. Secretary of State and retired U.S. Army Gen. Colin Powell called on Congress to support abortion coverage for military rape victims.

“Restoring abortion coverage to our servicewomen and military family members who are survivors of rape and incest would bring the Department of Defense in line with the policy that governs other federal programs, such as Medicaid or the Federal Employee Health Benefit program,” Powell, along with dozens of military leaders wrote. “At the very least, our military women deserve the same access to care as civilian women who rely on the federal government for their health care.”

Sen. Jeanne Shaheen, D-N.H., introduced the amendment which would allow the Department of Defense to cover the cost of abortions for servicewomen who are survivors of rape and incest.

Under current law, the Department of Defense is allowed to only provide coverage for an abortion if the servicemember’s life is in danger. There is no exemption for abortion coverage in the case of rape or incest, unlike many other federal health programs.

“The current policy is unfair and must be changed,” Powell and the other signers say in the letter. “Our servicewomen commit their lives to defending our freedoms; Congress should respect their service and sacrifice and provide them with the same level of health care coverage it provides civilians.”

The amendment is included in the National Defense Authorization Act which passed unanimously in the Senate last week.

The legislation is currently being worked on in a conference between the House and the Senate. If the provision is included in the final defense authorization bill each chamber, the House and Senate, will be able to vote on it during final passage of the bill.

The letter was sent to the Chairman and Ranking Member in the Senate and House Armed Services Committees, who will be in charge of hammering out a final Defense Authorization Bill that can pass in both houses of Congress.

Copyright 2012 ABC News Radio

Dec 102012
 

ABC/Donna Svennevik(WASHINGTON) — In a letter sent to key lawmakers on Capitol Hill former U.S. Secretary of State and retired U.S. Army Gen. Colin Powell called on Congress to support abortion coverage for military rape victims.

“Restoring abortion coverage to our servicewomen and military family members who are survivors of rape and incest would bring the Department of Defense in line with the policy that governs other federal programs, such as Medicaid or the Federal Employee Health Benefit program,” Powell, along with dozens of military leaders wrote. “At the very least, our military women deserve the same access to care as civilian women who rely on the federal government for their health care.”

Sen. Jeanne Shaheen, D-N.H., introduced the amendment which would allow the Department of Defense to cover the cost of abortions for servicewomen who are survivors of rape and incest.

Under current law, the Department of Defense is allowed to only provide coverage for an abortion if the servicemember’s life is in danger. There is no exemption for abortion coverage in the case of rape or incest, unlike many other federal health programs.

“The current policy is unfair and must be changed,” Powell and the other signers say in the letter. “Our servicewomen commit their lives to defending our freedoms; Congress should respect their service and sacrifice and provide them with the same level of health care coverage it provides civilians.”

The amendment is included in the National Defense Authorization Act which passed unanimously in the Senate last week.

The legislation is currently being worked on in a conference between the House and the Senate. If the provision is included in the final defense authorization bill each chamber, the House and Senate, will be able to vote on it during final passage of the bill.

The letter was sent to the Chairman and Ranking Member in the Senate and House Armed Services Committees, who will be in charge of hammering out a final Defense Authorization Bill that can pass in both houses of Congress.

Copyright 2012 ABC News Radio

Oct 112012
 

Alex Wong/Getty Images(WASHINGTON) — Mitt Romney appears to have altered his position on the Obamacare ban on denying insurance to people with pre-existing conditions in an interview with the Columbus Dispatch editorial board.

“You have to deal with those people who are currently uninsured, and help them have the opportunity to have insurance,” said Romney, according to the paper.

“But then once people have all had that opportunity to become insured, if someone chooses not to become insured, and waits for 10 or 20 years and then gets ill and then says, ‘Now I want insurance,’ you could hardly say to an insurance company, ‘Oh, you must take this person now that they’re sick,’ or there’d literally be no reason to have insurance.”

In the same interview with the Dispatch, he also argued that not having insurance does not in itself lead to deaths.

“We don’t have a setting across this country where if you don’t have insurance, we just say to you, ‘Tough luck, you’re going to die when you have your heart attack,’” Romney said. “Instead you go to the hospital, you get treated, you get care, and it’s paid for, either by charity, the government or by the hospital. We don’t have people that become ill, who die in their apartment because they don’t have insurance.”

Romney’s reference to a “choice” with regard to pre-existing conditions and his inclusion of giving opportunity to people “who are currently uninsured” would seem to contradict earlier statements from Romney and his own website, which suggest no ban on pre-existing conditions should be extended for people who don’t currently have insurance. A full transcript of the interview has not yet been posted by the Dispatch. The Romney campaign has not responded to a request for comment.

There were approximately 49 million non-elderly uninsured Americans in 2010, according to a Kaiser Family Foundation report that utilized U.S. Census data. More than 70 percent of those have gone without insurance for a year or more, according to the report.

Here’s what it says on Mitt Romney’s website about pre-existing conditions: “Prevent discrimination against individuals with pre-existing conditions who maintain continuous coverage.”

That has been taken to suggest that he favors a ban on insurance companies discriminating on the basis of pre-existing conditions, but not for people who are currently uninsured. “Continuous coverage” generally means three months, so presumably a three-month gap is allowed.

Romney has backed this assessment up, most notably in an interview during the GOP primary this spring with Jay Leno, when Romney was careful to stipulate that someone would need to have had insurance. “People who have done their best to be insured are going to be covered,” said Romney.

“If they are 45 years old, and they show up and say, ‘I want insurance because I have heart disease,’ it’s like, ‘Hey, guys. We can’t play the game like that,’” Romney told Jay Leno during a March appearance on the Tonight Show.  “You’ve got to get insurance when you are well, and then if you get ill, you are going to be covered.”

“People who have been continuously insured, let’s say someone’s had a job for a while and been insured, then they get real sick and they happen to lose a job, or change jobs, they find, ‘Gosh, I got a pre-existing condition. I can’t get insured,’ I’d say no, no, no.  People with pre-existing conditions, as long as they have been insured before, they are going to be able to continue to have insurance,” he said.

In the presidential debate last week, Romney said, “I do have a plan that deals with people with pre-existing conditions,” but he did not elaborate.

Copyright 2012 ABC News Radio

Oct 032012
 

iStockphoto/Thinkstock(WASHINGTON) — Only a few people — those lucky enough to get seats inside — were able to witness history last June when the Supreme Court announced its health care decision.  Now, as it begins its new term, the court has turned over audio recordings of the event.

Courtesy of OYEZ.org, you can listen to an excerpt of the opinions.  Chief Justice John Roberts begins by saying that the mandate could not be upheld under the Commerce Clause, but then he stuns the audience by announcing the law would be upheld as a taxing power.

Justice Anthony Kennedy then reads from the dissent he coauthored with Justice Samuel Alito, Justice Clarence Thomas and Justice Antonin Scalia.  The tone is polite, but the words are scathing.

Copyright 2012 ABC News Radio