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How Will Politics Impact Health Coverage After Midterm Elections?



November 2010

Now that midterm elections have passed, many people are wondering how the GOP's more empowered role in state governments will impact health coverage, particularly as the debate continues on over the healthcare bill.

Since Democrats still control both the Senate and the White House, the healthcare bill won't be overturned. However, what Republicans can do is to limit the funding for the bill, as well as to shape how it will be implemented in their own state.

This is due to the fact that the health coverage exchanges due to be up and running in 2014 are each to be implemented and managed by state governments. Sure, there are some federally mandated rules that insurance companies must stick by, including offering minimum coverage, no lifetime limits, and more.

But there is a lot of leeway in how states can manage their own health coverage. Governors can add mandates, control the funding and how it is used for the public, manage Medicaid costs by cutting as they see fit, and generally implement the law as they see fit.

The result will likely be that the health coverage exchanges and the laws of the healthcare bill itself will look very different from state to state. More Democratically inclined states could have insurance systems that are more heavily regulated and feature government oversight on premiums and coverage.

Republican states can, on the other hand, institute insurance in way that favors a more free-market approach with minimal interference between state legislators and insurance companies.
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