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Brewer mulling fate of health exchange

Don Hughes, Gov. Jan Brewer's chief policy adviser on health care, answers an audience question during Arizona Capitol Times' Morning Scoop on Health Care Oct. 9. Laurie Lyles, president and ceo of the Arizona Hospital and Healthcare Association was also on the panel. (Josh Coddington/ArizonaCapitol Times)

Gov. Jan Brewer is preparing to implement the state’s health care exchange – though she hasn’t officially decided whether or not the state should run the exchange, and hopes it won’t be necessary at all after the November election.

During a panel discussion of health care issues this morning that was hosted by the Arizona Capitol Times, Don Hughes, the governor’s health care policy advisor, said Brewer hopes Mitt Romney is elected president  and that Republicans get a majority in Congress and decide to repeal the federal health care law known as “Obamacare.”

But should the election go the other way, Brewer is weighing her options between letting the federal government run the state’s exchange system and implementing a state-run exchange.

“We continue to push for a total repeal of the Affordable Care Act as the best way to go, but the governor realizes it is the law now, settled or unsettled,” Hughes said. “And we have taken some steps to comply with the law so that Arizona is ready to implement – if that’s the decision we decide to (make).”

The comment came during the Capitol Times’ Morning Scoop panel discussion on health care. Other panelists included Sen. Nancy Barto, Rep. Eric Meyer and Laurie Liles, president and CEO of the Arizona Hospital and Healthcare Association.

Hughes said that if the governor decides that running the exchange is the best thing for the state, and if the Legislature goes along with her, the state is ahead of the curve in preparing to implement the state-based exchange system.

But Barto emphasized that the state should “dig in our heels” and fight the federal health care law, saying the choice between letting the federal government run the exchange and running the state’s  own exchange isn’t much of a choice at all; the state is still carrying out the federal law.

“The fact that hundreds of millions of dollars continue to be waved in front of states to set up state insurance exchanges should tell us a lot,” she said. “States are in a place where we have great leverage to say no and move forward towards repeal, because frankly the federal government needs the states more than the states need the federal government on this issue.”

Meyer said that the state should move forward with the exchange as soon as possible to settle uncertainty  in government, the health care industry and business. He said that making sure people have health care will ultimately reduce the costs of the system.

“The argument to not be in the exchange because there are certain businesses that aren’t providing health care to their employees doesn’t make sense to me,” he said. “What that does is let those businesses have a free ride on providers like me who work in the ER, and see their employees for free. And those uncompensated costs are then passed on to the hospitals and to the rest of us.”

Liles said that her organization supports Arizona running its own exchange over allowing the federal government to control the program.

“In all likelihood we will have some kind of exchange here in Arizona… Our preference is that we focus on the best way in Arizona to get most of those 1.3 million people coverage that’s affordable.”

The state has until November 16 to decide whether to run a state-based insurance exchange system or let the federal government run Arizona’s exchange.

Although Hughes said the governor won’t make a decision until after the election, he said she is fully prepared to implement a state-based exchange, if the federal law is not repealed and Arizona has to make a choice.

“We are simply doing the necessary due diligence to put Arizona in a position where we don’t cede any more authority to the federal government than we have to,” he said.

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