The refusal to set up exchanges is a no-brainer. The federal government’s decision to impose a 3.5 percent surcharge on coverage sold through the exchanges indicates that states would expect similar costs to them that will go only higher in time. One ballpark estimate puts the per enrollee cost at $97, but Maryland’s looks to come in at over $200, and the federal government will pay for these costs only through 2015. With the probability that the whole unworkable law will unravel in the future, why should Louisiana commit itself now to extra costs requiring extra revenue when state exchanges hardly can deviate from regulations that would run federal exchanges anyway?
While some quarters complain
about the expansion rejection aspect, which has no legal deadline for
acceptance, the wisdom
expressed by the likes of Gov. Bobby
Jindal and Rep. Bill
Cassidy for rejection continues unchallenged and, if anything, grows more
compelling as time passes. The law allows premium support for non-disabled
adults, such as single earner of income between $11,200 and $15,400 annually,
through the exchanges. But for those individuals below that figure states would
have to follow the fee-for-service model if they accept the expansion, which is
paid for entirely by the federal government for the first three years but then
tapers to 90 percent.