On March 23, 2010, President Obama signed the Patient Protection and Affordable Care Act (ACA) into law. It includes a number of broad, sweeping changes to America’s health care system, including the creation of health benefits exchanges in which individuals and small business owners in every state can purchase qualified coverage.
Multiple studies commissioned by the Ohio Department of Insurance determined Ohio’s competitive marketplace would be negatively impacted by the ACA. The studies concluded that premiums will increase for consumers and Ohio will absorb significant costs. If Ohio selected a state-based exchange, the state would be required to get approval from the federal government on all aspects of its operation and set-up. Making a decision has also been difficult as the federal government still hasn’t provided rules giving clarity and direction to states regarding issues such as benefits offered by plans sold on the exchange.
Based on the cost of a state-based exchange, lack of flexibility and the lack of guidance from the federal government, Ohio has decided to not run an exchange. Instead, it will let the federal government take on that responsibility. Ohio will, however, maintain authority over important parts of our insurance market and Medicaid systems. Ohio will continue to oversee plan management for health insurers and manage Medicaid and Children’s Health Insurance Plan (CHIP) eligibility for its citizens.