Can state-run exchanges work without the ACA?


What would happen if state-run exchanges disconnected completely from the Affordable Care Act and acted as independent agents? Is such a thing even possible?

On one hand, some argue, it could be a good thing: Consumers may view purchasing health insurance in a different light--one that is completely void of government influence.

But others say it could cause more harm than good: Thousands of consumers could lose their coveted health insurance if a state exchange severed ties with the ACA.

The questions arose when Kentucky's senior senator, Mitch McConnell (R), and Kentucky's Secretary of State Alison Lundergan Grimes (D), butted heads during a debate earlier this week.

Right from the time open enrollment began, Kentucky experienced success. The state's exchange, Kentucky Kynect, signed up more people for private insurance and Medicaid than any other sate on a per capita basisFierceHealthPayer previously reported. 

McConnell doesn't deny Kynect's success--he's all for the state-run exchange. What he's not all for, however, is the site's connection with the Affordable Care Act. 

McConnell said that by ridding Kynect of all healthcare reform ties, consumers could enjoy purchasing health insurance without political ties, notes The Washington Post. He said doing so would keep in mind the best interest of the country. 

Many, including Grimes, saw it as a gaffe.

Suggesting the two can be separated is "like saying that Google should cease to exist but that should live on," writes Juliet Lapidos in an opinion piece for The New York Times

While the game of political football between McConnell and Grimes is entertaining, others note the stakes are high. Breaking away from the ACA would cause some 500,000 Kentucky residents to lose their health insurance, argues Danny Vinic over at the New Republic

And, notes a New York Times blog post, the site was built by the federal government, which dished out $200 million in grants. The successful state-run exchange would certainly collapse without that kind of funding--as would exchanges in other states that would try to separate their health exchange sites with the federal

For more:
- read The Washington Post piece
- check out the New Republic article
- here's The New York Times story

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