The Washington Post

Republicans governors vs. Obamacare

Taking a swipe at Obamacare, New Jersey Gov. Chris Christie vetoed Thursday his Democratic legislature’s bill that would have laid the foundation for implementing the federal health reform law.

New Jersey Gov. Chris Christie on Thursday vetoed legislation that would have created a state health insurance exchange. (Jonathan Ernst/Reuters)

“Because it is not known whether the Affordable Care Act will remain, in whole or in part, it would be imprudent for New Jersey to create an exchange at this moment in time before critical threshold issues are decided with finality by the Court,” Christie said in a Thursday statement.

Christie is only the second Republican governor to veto such a bill — the first was New Mexico Gov. Susana Martinez, who did so last year — but many more have cited the Supreme Court to delay action on implementing the Affordable Care Act. Alabama recently delayed action on a health exchange citing the looming uncertainties, as has Illinois.

The Supreme Court decision isn’t that far off at this point: It’s expected to come down in late June. In about two months time, these states will know a lot more about whether Obamacare still stands. The big question then is, how much can they do?

States that get going after the Supreme Court decision will have about six months to tackle a massive to-do list: Pass legislation that authorizes an exchange, hire a board to govern it, find vendors to set up the technical aspects and have it nearly up and running by Jan. 1, 2013, so that it can begin accepting customers next fall.

The conventional wisdom in health policy circles right now is that states that have not taken steps toward implementation yet just will not have the capacity to do so, on such a short time frame. Some of it has to do with the sheer scale of the task; California, for example, has been working on its exchange for over a year now, and is still far from being done.

There are technical roadblocks, too, like the fact that there’s a finite number of vendors — the technology companies that know how to run insurance marketplaces, most of whom already have a slew of contracts.

In states like New Jersey, where work has not started yet, it looks increasingly likely that a state-run exchange will not be in the cards. If the Supreme Court upholds Obamacare, then it will likely be the federal government stepping in to set up the health insurance exchange in New Jersey — and in any other states that have yet to get moving.


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