In writing about the IT jobs expected to come from health reform last week, I failed to mention one aspect of the state insurance exchanges to be set up.
As Ken Terry at FierceHealthIT points out, if states don't set up the exchanges, the federal government will assume responsibility for the online marketplaces for health insurance. (Full disclosure: I write for FierceHealthIT, too.) Though the Supreme Court struck down withholding payments to states that refuse to expand Medicaid, expansion is expected in most states, adding up to 16 million people to the rolls. Terry says that will require most states to upgrade their information systems, adding to the demand for health IT.
The IT work on the exchanges, to some degree, though, still depends on a whole lot of politics.
Republican-led states such as Kansas and Alabama have balked at working on the exchanges, expecting a different ruling from the Supreme court. Now Republican lawmakers led by Sen. Jim DeMint, R-S.C., and Rep. Michele Bachmann, R-Minn., are urging states to skip the exchanges altogether, according to The Hill. They wrote to governors:
By refusing to create an exchange, you will assist us in Congress to repeal this violation which will help lower the costs of doing business in your state.
They also wrote:
Do we allow this reprehensible law to move forward or do we fully repeal it and start over with common-sense solutions? The American people have made it clear that they want us to throw this law out in its entirety.
Incredibly, when Fox News pressed Senate Minority Leader Mitch McConnell, R-Ky., about the GOP's alternative proposal, he kept insisting "That is not the issue," according to Think Progress.
Meanwhile, California, the state with the largest number of uninsured, 5 million, has pledged to make shopping for health insurance as easy "as buying a book on Amazon or shoes on Zappos," Kaiser Health News reports.