Websites where consumers will be able to shop for health insurance are a lynchpin of the nation's new health care law and have a history of conservative support, a top federal official said Wednesday.
"You could say Obamacare was Romneycare before it was Obamacare," said Joel Ario of the Office of Insurance Exchanges in the U.S. Department of Health and Human Services. He spoke at a meeting in Chicago of the industry trade group America's Health Insurance Plans.
Potential Republican presidential candidate Mitt Romney was persuaded by the conservative Heritage Foundation to support online insurance exchanges when he was governor of Massachusetts, Ario said. The exchanges became a key to Massachusetts' health overhaul, which in turn became the model for nation's law.
Since the election, President Barack Obama's administration has been stressing Republican ideas in health care overhaul. Obama himself said on CBS' "60 Minutes" that he thought he would find common ground with Republicans by advancing proposals that had been introduced by Republican administrations.
The new health care law asks states to build the web-based exchanges by 2014 when most individuals will be required to buy health insurance. Ario said Wednesday his office will issue guidance to states in the next few weeks.
Individuals and small business owners would be able to pool their purchasing power through the exchanges. And the exchanges will allow one-stop comparison shopping, similar to Travelocity for airfares.
What's more, individuals would learn from the sites whether they qualify for government subsidies to help pay for their insurance or whether they're eligible for Medicaid, which will greatly expand to cover more people under the health overhaul.
States could limit which health plans will be offered in the exchanges or they could allow unfettered competition, Ario said.
"Eventually, states will learn from each other and we may end up with a federal model at some point," Ario said.
The online marketplaces could be expensive for states to create, but Ario said the law is clear that the federal government is responsible for "all necessary costs" of setting them up. And the law says the federal government will step in and build them in states that don't.
Illinois Department of Insurance Director Michael McRaith said it's unlikely that states opposed to federal control will "defer to Washington to establish an exchange."
McRaith said the first states to build exchanges have done so with Republican leadership. Laws establishing the first exchanges, in Massachusetts and Utah, were signed by Republican governors. And in October, Republican Gov. Arnold Schwarzenegger signed legislation in California establishing an insurance exchange.
There's another indication that most states will participate: Only two states, Alaska and Minnesota, didn't apply for $1 million federal grants to pay for planning the exchanges.
Ario was an insurance regulator in Oregon and later in Pennsylvania before taking the post in President Barack Obama's administration earlier this year. In Pennsylvania, Ario opposed the merger of two large health insurers and battled with insurers over competition and rate increases.
To the insurance industry group Wednesday, he stressed the opportunities of health overhaul for new customers. The law is expected to expand coverage to 32 million Americans who now are uninsured.
"Thirty-two million new customers. Everybody has to buy the product and many of them come with subsidies," Ario said. "I really just don't know what's not to like in that for you guys. It's a pretty big opportunity."
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