By Bill Britt
Alabama Political Reporter
On Thursday the members of the Alabama House of Representatives unanimously passed HB245.
In a vote of 92-0 the house passed legislation that would establish a statewide healthcare exchange.
HB245 is a response to the Patient Protection and Affordable Care Act, also known as ObamaCare.
The Affordable Care Act mandates that all states must form their own insurance exchanges or fall under a system instituted by the federal government.
“A vote for this bill is a vote for AlabamaCare, and vote against ObamaCare,” said Dr. Jim McClendon (R-Springville) the Chairman of the House Health Committee.
The bill sponsored by Greg Wren (R-Montgomery) would set the parameters for an Alabama Heath Insurance Exchange.
Wren has worked diligently over the past two years to understand, write and champion a statewide system said in a recent interview, “This is a mandate that was thrust upon the state with tremendous obligations. We must act before the Federal government takes over.”
As a candidate Dr. Robert Bentley had made creating a healthcare exchange for Alabama a part of his campaign for governor. As governor he has worked to develop such an exchange but did not favor the passing of HB245.
According to McClendon a spokesman for the governor stated recently that the governor preferred to wait on a court ruling in June, which will be after the legislative session is over. McClendon publicly stated in a recent House Health Committee meeting that as Chairman of Health, he could not condone passively inviting the Feds to Alabama to commandeer decisions rightfully ours to make.
The Affordable Care Act gives states until December 31, 2012 to establish their own healthcare exchange or the Federal government will create a exchange for them.
Representative Joe Hubbard (D-Montgomery) said of the situation facing Alabama. “Whatever side of the Federal healthcare policy you line up on, the issue is that there is a mandate for the states to have in place a healthcare exchange by 12-31-2012,” said Hubbard. “If the a state does not have an exchange in place by that date the federal government will come in and set one up for them.”
In March, the US Supreme Court heard arguments to overturn The Affordable Care Act. The court even set aside an unprecedented three days to hear the case. Their decision is expected to be announced some time in late June Hubbard explains, “We only have six legislative days left in this session. If we are going to have an exchange in place the time is now.
The competing interests are keeping the federal government out of our healthcare system or waiting to see if the court overturns the exchange portion of the law.
If we wait on the Supreme Court and the court does not overturn the exchange portion of the law we are stuck with the feds having their hands in our healthcare system. That is an unacceptable option.”
Hubbard points out that if the court uphold the exchange portion of the Affordable Care Act and there is not a plan in place the legislators are faced with only two options, let the federal government dictate Alabama’s healthcare or call a special session of the legislative branch to write a heath care exchange law.
Almost a year and a half ago the Governor asked McClendon and others to establish a commission that would study and recommend the implementation of the statewide healthcare exchange in compliance with the the Affordable Care Act. Millions were spent on the governor’s commission and the report was delivered to the governor’s office in December.
McClendon who was a part of the governor’s commission is a firm supporter of HB245. “We the people of Alabama are capable of running our healthcare without carpetbaggers from Washington coming down here to tell us how to run our state,” said McClendon. “A failure to act on this legislation is like inviting General Sherman to stage another fiery march through Alabama.”
Many have been perplexed by the Bentley administration’s resistance to establishing an exchange ahead of the federal deadline.
Wren has stated numerous times that the guidelines for the Federal Exchange have yet to be written. “No one knows what it will look like. If Alabama does not act we will be stuck with whatever the Obama administration decides for Alabama,” said Wren. “I will turn over every rock in the Legislature to prevent that from happening. I will not stand by and let that happen even if we only as a defensive measure we need to have a bill in place. That builds and exchange through a governance board.”
While the governor’s office lobbied hard on Thursday to defeat HB245 the bill passed with complete and unanimous bi-partisan support. After the vote one legislator was heard saying “Let me summarize this defeat of the governor’s effort to kill the bill: ‘Legislature 92, Governor Zero.’”
The governor’s office has given considerable time, energy, effort and taxpayer dollars to creating a superior, state of the art healthcare exchange for Alabama.
But during the hearings of the House Health Committee there has been a constant resistance to HB245.
Alabama is among the states that have challenged the constitutionality of ObamaCare.
Many lawmakers hope to see the Affordable Care Act overturned by the Supreme Court in June.
Wren says he has worked to see ObamaCare repealed. He says that he is also completely supportive of the litigation that would overturn the Affordable Care Act but Wren says he also believes the state must be proactive.
“The sheer weight of the problem for Alabama and all states is that this is still the law of the land.”
Thursday’s vote seems to support the idea that Republicans and Democrats agree betting Alabama’s future on what the Supreme Court may or may not do, is a gamble too risky to make on the backs of the people of the state.
“Now, the Governor has said, ‘Let’s wait and see what the Supreme Court decides,’ but if we do that then the only way for us to set up our own exchange is to call a special session to the tune to half a million dollars, to address that singular issue. To me that is fiscally irresponsible,” said Hubbard.
It has been suggested that the Bentley administration could enact a healthcare exchange by executive order.
This may be because on June 30, 1967, then Governor Lurleen B. Wallace signed Executive Order Number 8 official forming Alabama’s Medicaid program.
An attorney inside the administration who would not speak on the record said, “If this is the advice the Governor is receiving I hope that are prepared for a fight with the Legislature. I don’t believe any governor would be allowed to get by with what Lurleen Wallace did, the times have changes since those days.” The attorney said that only the legislative body can appropriate money under the law and therefore it is erroneous to believe the executive has that kind of power.
Hubbard points out that there is no risk in passing HB245, “I have work with Representative Wren on this bill. The point is to have a piece of legislation in place in case the Supreme Court does uphold the exchanges so that we are ready to institute our own plan.”
Hubbard says there is a provision in the law that if the court strikes down the healthcare exchange portion of the Affordable Care Act then HB245 dissolves, it will in effect self-distruct.
The House has cast their vote unanimously to establish a health care exchange it will now be in the hands of the Senate to decide next steps. However with just six legislative days left in this session no one can be sure of the bill’s fate.