Pence Wants Federal Government to Handle Indiana’s Health Insurance Exchange

Because he doesn’t like Obamacare, future Governor Mike Pence has recommended something of a passive-aggressive course of action by Indiana in terms of (not) establishing a state-based health insurance exchange under the Affordable Care Act. His letter to Gov. Daniels is here. This has the effect of increasing the federal control over Indiana’s health care system. (This might not be a bad thing, policy-wise, but choosing increased federal control is a departure from Pence’s stated philosophy about wanting to reduce the federal government.)

Under the terms of federal law, states “may opt out of running their own exchange, in which case the federal government will step in to create an exchange for use by their citizens.”

Wikipedia has an explanation of the health care exchange concept here. Generally speaking, it creates one stop shopping for consumers where they can get an apples-to-apples comparison of policies; at least for a basic benefit package. Policies offered through the exchange: 1) Must be guaranteed issue: insurers will not be permitted to refuse to insure any individuals; 2) Must limit price variations: prices will vary based on four factors and not beyond a total factor of approximately 10; 3) Will be offered in four comparable tiers ranging from bronze to platinum with limited out of pocket expenses; 4) Have strict regulations on rescission (practice by which insurers take your premiums until you get sick then disqualify you for technical defects in your application); and 5) Lifetime and annual limits eliminated.


  1. jharp says

    Pence’s governor elect office number is 317 569 0709

    I phoned my thoughts in yesterday.

    I have no idea what the best solution is and I’m sure his dumbass doesn’t either. And I think the letter makes it obvious that he is simply pandering to his base.

    Anyways, I let it be known that I thought we should have an intelligent debate about it and keep all options on the table including maybe combing a program with Ohio.

    And that letting the federal govt run the exchange didn’t seem very conservative republican like.

    Should be interesting how it turns out.

  2. HoosierOne says

    These are the same people preaching local control as they take over the local public schools systems through state taxes and mandates and try to obliterate local contracts in one fell swoop. They are just petty hypocrites, as far as I am concerned. Passive-aggressive describes them to a tee. I wish Obama had come out in favor of breathing and the whole lot of them had decided to hold their breathe – permanently.

    • Joe says

      If they were for local control, they would not have pushed property tax cuts. They would have encouraged people to vote for officials who did not want higher taxes.

  3. Carlito Brigante says

    I heard this am on NPR that the feds are giving the states one more month to decide and have also offered a “federal-state partnership” option. I suspect that now that the election is over, the pandering and the far-right buttlicking from the winning republican governors can stop, and the ACA is the law of the land, Republican governors can embrace reality (and bring in federal aid and expertise) and create the exchanges without much of a political price to be paid. Scott of Florida has signaled that he is interested in forming a state-run exchange.

  4. jharp says

    Interesting. Makes sense to me but my mind is not made up.

    Most Republican States Won’t Build Exchanges and That Is a Good Thing

    Financially this should be far more efficient. Creating one of these exchanges is an incredibly expensive IT investment but adding more people to an existing system should be a rather small cost. It should be much cheaper for the federal government to just build one system and use it in 30 states, rather than make 30 states waste money building 30 different systems.

  5. Chip says

    As a member of Congress, Pence has been purchasing insurance in what amounts to an exchange run by the federal government. I guess he is happy with the job they have done and would like the feds to do the same for Hoosiers.

  6. jharp says

    “As a member of Congress, Pence has been purchasing insurance in what amounts to an exchange run by the federal government. ”

    The part about Pence choosing a plan from and exchange run by the federal government is true. However, taxpayers are paying for most of it.

    I asked his office the other day how much Pence was required to pay and no one knew.

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