Friday’s deadline, November 16, calls for each state, including Wisconsin, to give the federal government a “blueprint” for a Health Information Exchange. State exchanges compare the benefits and costs of insurance policies and post the results online so people and employers can choose which are the best values for them. They will also make electronic patient records accessible for treatment and research for the public health. As I noted in my election-eve blog post, exchanges (also called HIEs) are central to health care reform by making better consumer choices possible.
State blueprints would resolve such choices as whether the exchange will be a private non-profit company or a state agency, and what consent and protections are in place for patient privacy. Overall, a state can choose whether its exchange will be run by the state, in a partnership with the federal government, or by the federal government. If a state doesn’t provide a blueprint, its exchange will be formed and run according the rules and models in federal regulations that will be issued soon.
A number of states had exchanges already in place and could adapt them. Several Republican-led states have made a point of refusing to plan, waiting to see if the election changed the health reform landscape. It appears that several Republican governors in fact have made plans to meet tomorrow’s requirements. This week, the governors asked for an extension of the deadline. At least in Wisconsin’s case, it would have to be a long one since the legislature doesn’t return until January. It would then have debate and compromise to accomplish before creating anything like a blueprint.
Governor Scott Walker convened a task force to examine private sector alternatives to a state exchange, but appeared to make no such plan. On Wednesday he said that he would decide what to do on the day of the deadline, suggesting some blueprint for Wisconsin might have been created. Wisconsin has a limited, voluntary organization serving the purpose. Governor Walker said he thinks that a state-run exchange would be better; one set up now would not really be run by the state. A radio broadcaster for a Republican-leaning audience put it less diplomatically this morning, asking — why not let the feds do it so it’s their fault when it fails? The answer no doubt will generate comments tomorrow.