Remember how Mr. Romney would always explain the difference between his Massachusetts health insurance plan and Obamacare by saying this question should be left to the states and a one size fits all formula would not work?

      Well, the deadline for submitting a state exchange plan has now passed and surprisingly it is the Republican governors who almost uniformly are rejecting the state insurance exchange option in favor of having the federal government run the insurance exchange in their state. Some governors, like NJ governor Christie, have even vetoed bills passed by the state legislature to set up a plan.

     To date, only 19 states have opted to run state exchanges and most of these are Democratic controlled states.

      Oddly enough California seems most on the ball – ads for Covered California have already been drawn up and the state is taking bids from insurers to provide plans that will be offered in the exchange.
Except that the Obama admin is no longer calling them “exchanges.” Now they are just “marketplaces.” The exchanges will offer gold, silver, and bronze plans to consumers.

      You can enroll in the new exchanges beginning October 1, 2013 and they formally begin coverage on January 1, 2014. Obamacare sets minimum requirements for all plans but insurers are always free to offer more for the same buck. Old guys should be quite happy as insurers cannot charge more than three times what they charge their youngest insured. So private insurers predictably will charge the young and healthy more who must buy or pay the Obamacare penalty, unless the exchanges hold the line on costs and benefits.

 My prediction – utter consumer chaos next fall as we all wonder whether the best deal is the state exchange, the federal exchange, private individual plans, or our existing group plans, or with respect to the young and healthy, just paying the penalty.