New Jersey Gov. Chris Christie (R) became the latest state chief executive to rebuff President Barack Obama's health care reform law Thursday by vetoing a bill that would have created an online marketplace for uninsured residents to shop for health insurance.
For the second time this year, Christie rejected legislation passed by New Jersey's Democratic-controlled legislature that would have established a state-run health insurance exchange under Obamacare. The exchanges will be the gateway to health insurance coverage and financial assistance for individuals and small businesses under the 2010 federal law. New Jersey is now the 19th state to decline to create its own exchange, which will leave the federal government in charge of these new marketplaces in those states.
Christie said the health law, known as the Affordable Care Act, doesn't give states enough leeway to design health insurance markets for their residents and that federal authorities haven't provided enough information about how the exchanges would work.
"I will not ask New Jerseyans to commit today to a state-based exchange when the federal government cannot tell us what it will cost, how that cost compares to other options and how much control they will give the states over this option that comes at the cost of our state's taxpayers," Christie said in a news release. "We will comply with the Affordable Care Act, but only in the most efficient and cost effective way for New Jersey taxpayers."
Christie met with Obama at the White House Thursday to discuss federal relief funding in the aftermath of Hurricane Sandy.
Around 25 million people are expected to gain health insurance coverage through the exchanges by 2022, according the Congressional Budget Office. The exchanges also are the means people will use to find out whether they qualify for the health insurance tax credits available to people who don't get health benefits at work and earn between the federal poverty level, which is $11,170 this year, and four times that amount.
People with incomes of up to 133 percent of poverty, $14,856 this year, will qualify for Medicaid benefits, but only in states that opt into Obamacare's expansion of that program. To date, nine states including Texas, Louisiana and South Dakota have said they won't add poor people to their Medicaid rolls. Wyoming Gov. Matt Mead (R) told legislators that the state also should not expand Medicaid, the Associated Press reported Wednesday.
The federal government has the authority under Obamacare to create health insurance exchanges in states that don't enact their own, but the law was designed for federal authorities and states to share the responsibility. Lack of cooperation from states and poor coordination between levels of government could make the exchanges less effective at enrolling uninsured people into health coverage programs.
States have until Dec. 14 to inform federal authorities of their plans for health insurance exchanges. Seventeen states and the District of Columbia already are moving ahead with their own exchanges, five states intend to jointly operate them with the federal government, and nine haven't made announcements, according to the Henry J. Kaiser Family Foundation. One of those officially undecided states, Virginia, is unlikely to create a state-run health insurance exchange, William Hazel, the state's secretary of Health and Human Resources, said at a conference held by the National Conference of State Legislatures Thursday.