Donelon, Cassidy say idea of ‘Obamacare’ exchanges has merit

Louisiana Department of Health and Hospitals Secretary Bruce Greenstein says the state should not set up a health insurance marketplace called an “exchange,” citing the expected cost. Insurance Commissioner Jim Donelon and Congressman Bill Cassidy, R-Baton Rouge, each defer to Greenstein on the details, but both say the concept of exchanges, part of federal health care reform, has merit. “Exchanges are a vehicle to give greater consumer access to shop for the best product in their price range,” Donelon says. Blue Cross Blue Shield of Louisiana controls about 75% of the state’s health insurance market, he says, adding an exchange could improve the state’s market if the federal requirements are not too onerous. Cassidy says exchanges are rooted in a “Republican idea” and could arm consumers with information, although exchanges also have the potential to establish artificial price controls. Greenstein says an exchange is the “operationalization” of the insurance mandate that has been challenged as unconstitutional. The law says each state can create its own exchange or defer to the federal government. Greenstein says it’s hard to estimate how much it would cost Louisiana to operate an exchange, because the federal rules are not clear and complete. Officials in Alabama, a state of similar size and demographics, estimate an exchange in their state could cost between $34 million and $49.6 million in 2015, DHH says. Senate Bill 744 calls for the creation of a Louisiana exchange. The Pelican Institute argues against the bill in a summary you can see here; while the Louisiana Budget Project makes the opposite argument here. —David Jacobs