Fear The Part-State/Part-Federal Exchange Frankenstein Monster

The House health care bill's single national exchange with federal regulatory enforcement mechanisms is clearly superior to the Senate's idea of small, state-based exchanges with enforcement by state insurance commissioners. Under the House bill, if states think that they can do a better job than the national exchange, they have the right to opt out and set up their own exchange and enforcement mechanisms.

There is no logical reason to want to go with the Senate's state-based exchanges if your desire is to do what is best for regular Americans. If your desire is to help private insurance companies, then the Senate's structure is the way to go.

But, news today has it, instead of getting what is best for the American people, it appears we are going to get some terrible Frankenstein monster that is part national and part state-based.
How to structure the exchanges consumers would use to buy insurance is one of the major outstanding questions. House Democrats favor a single, national exchange while the Senate has endorsed multiple state-based exchanges

Van Hollen described a kind of middle ground that would have a "national component" and more uniformity.

I really don't like the sound of this. Federal-state hybrids don't tend to have a good track record. To me, this sounds like a recipe for insurance companies to game the system by slipping between the gulf of what the state regulator is doing and the federal insurance regulatory system is doing.

I guess Ben Nelson doesn't want a national exchange, so we don't get a national exchange. I'm truly amazed that Democrats are letting Ben Nelson ruin our potential health care system, destroy the popularity of the bill, and possibly cost Democrats control of the House. At some point, you would think they would say “enough is enough” to this 60-vote nonsense killing their chances of re-election and ruining our government.

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