Question: The Republicans in Congress have claimed that they will vote to repeal the health care reform bill tomorrow. I don't believe they can repeal the law, but could they hamstring the California Exchange by cutting federal funding?
Answer: I don't think the health insurance exchanges are high on the Republican hit list. For one thing, the exchanges have the advantage of combining the ideas of both the Republicans and the Democrats. The Democrats have always wanted universal coverage and the Republicans have always wanted a private health insurance system. With an exchange program, you get both. It remains a private system. There's no government health plan. And you have the potential for making it universal.
Exchanges were first adopted in Massachusetts and then Utah under Republican governors. The California Health Benefit Exchange was established in 2010 under a Republican governor.
Other models that have set a precedent for the exchanges, such as the Federal Employees Health Benefits Program (FEHBP), have been successful. FEHBP has been run by the federal government for many years. It allows employees to choose from private insurance plans and to change carriers during open enrollment once a year. And that's worked very well. People see it as the gold standard among health plans. The exchange idea in reform is to apply this concept to people who are not federal employees, offering the same choices among private plans.
For these reasons, I can't see the Republicans going after [the exchanges.