Where are they now?

Ezra,

Curious on the finance side.

Increases in benefits, with a number of delays and cuts in taxes/fees.

Altogether, it feels like a $100 billion gap that now needs to be filled. Any comments from WH on how this gets financed?

Ya, I saw that they were dropped. How bad is that going forward? Will that make it much harder to add a public option in the future?

If the exchanges are not considered appropriate for the budget reconciliation criteria, would there not also be the same problem problem with the new White House idea of the Health Insurance Rate Authority?

I understand the argument for a national exchange, can't pretend that its absence isn't a disappointment.

I watched the Governor's meeting on C-Span this past weekend. The meeting focused on health care. I was impressed with how informed, engaged and active the governors are in dealing with the health care. Maybe we'll see some unforseen benefits from the greater experimentation afforded by state-level solutions.

Single state proposals are complicated by the fact that many state employee health plans and state health programs are administered by 1 or 2 firms. It creates monopolies that are difficult to compete against.

Does it look like the state exchanges in the final plan will be set up to withstand adverse selection?

Ezra:

The exchanges are in Obama's proposal. His proposal should be read as a list of changes to the Senate bill--therefore, if it isn't mentioned in the proposal, assume that they're sticking with whatever the Senate bill said.

This was made clear in a conference call this morning, and it also is spelled out in this NYTimes story:

http://www.nytimes.com/2010/02/23/health/policy/23health.html?pagewanted=2

"He opted for the Senate’s proposal to create state-based insurance exchanges, or marketplaces, rather than a single national exchange as proposed by the House."

Just a thought: I expect the Republicans will mount efforts to dismantle or obstruct any health care legislation the Dems enact.

Would State exchanges perhaps be somewhat more immune from REpbulican mischief? You really only need a few models to survive and thrive for the concept to eventually spread nationally.

AMP1,

Thanks for clarifying.

AMP1: The question is about who will regulate the exchanges: state governments, or the federal government. The fear is that state's will more often bow under the pressure of insurance companies, and largely are unequipped to be tight regulators. The senate bill had state-regulated exchanges. Early leaks had implied that this would change to federally regulated exchanges. Obviously, that doesn't seem to be the case. Which is a major blow. Not sure why it's not in there.

Ezra, anything more you find out on this front please share. And please try to find out more on this front.

this news made me fffffuuuuuuu. i hope it gets resolved..