Debate unfolds over state’s role in health care

VANCOUVER, Wash. — The debate over Washington’s role in implementing the federal health care reform law is playing out in Olympia this session with dueling bills.

One House measure would prohibit the state from spending state money to implement President Barack Obama’s health c

are overhaul law.

Meanwhile, a Senate bill would authorize the state to continue work on creating health care exchanges with $1 million in federal money, as required by the 2010 law.

The debate is unfolding against a high-stakes political backdrop as well as legal uncertainty, the Columbian newspaper reported.

Democratic Gov. Chris Gregoire and Republican Attorney General Rob McKenna are on opposite sides of the issue. McKenna is considered a leading candidate for governor next year.

McKenna was one of the first state attorneys general to join a lawsuit filed by Florida, which prompted anger from Gregoire. The governor fumed at the time: “I don’t know who he represents. He doesn’t represent me.”

The Florida lawsuit argues that the bill’s mandate requiring individuals to buy health insurance or pay a fine is unconstitutional. On Jan. 31, U.S. District Judge Roger Vinson in Pensacola, Fla., ruled the entire health care overhaul law is unconstitutional. The Justice Department has said it would appeal.

The Florida judge’s ruling was the latest in a series of contradictory rulings that will likely need to be resolved by the Supreme Court. In the meantime, states are caught in the middle.

“With the court’s recent ruling, and with our state facing a $4.6 billion shortfall, it would be irresponsible for us to spend any more state dollars implementing a federal law that may never go into effect,” state Rep. Joe Schmick, R-Colfax, who introduced House Bill 1804, told the Columbian.

Schmick’s bill, however, won’t get a hearing, according to state Rep. Eileen Cody’s office. The Seattle lawmaker chairs the House health and wellness committee, and her office noted that the state Office of Insurance Commissioner is spending federal money — not state dollars — to implement the health care reform law.

Meanwhile, Sen. Karen Keiser, D-Kent, who chairs the Senate health and long-term care committee, held a hearing Feb. 3 on her bill to move ahead to establish health insurance exchanges consistent with the federal law. Senate Bill 5445 was requested by the governor.

She told the Columbian newspaper that it would be a mistake to allow the federal government to design the approach to the health insurance exchanges.

Gregoire supports moving ahead with the federal plan, said her spokeswoman Karina Shagren.

“There have been judicial opinions, but the governor is confident that health care reform is going to be found constitutional,” Shagren said.

In a statement, McKenna said he thinks the Supreme Court should rule as quickly as possible on these constitutional issues and that the decision on whether or not to suspend implementation of the federal health care law is up to the governor and state legislators.

States are required to establish health insurance exchanges by Jan. 1, 2014. These exchanges would pool a range of individual and small-group health insurance policies and allow people who lack health coverage to buy into them. Federal subsidies would make the coverage affordable for low-income residents.

“We have two years to get this up and running. We have to maintain our momentum,” Keiser said.

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