Pros And Cons Of State-Care Exchanges

The debate over healthcare and health insurance has been disputed over for many years among politicians. The question many of them ask, along with the citizens of America, is simply whether the state or federal government should control health care. While there are pros and cons to both sides, there is a clear answer to this long fought over issue. Health care should be run by states because they manage their health insurance exchanges more efficiently, maintain the cost and quality of health insurance and care, and are constitutionally and lawfully accountable.

States should run the health care system because state-run health exchanges are managed more efficiently than federal-run exchanges. Some of the effectiveness of state-run exchanges

State-run healthcare can control the cost of insurance by controlling premium rates. According to Louis Norris, 7 of the 13 states with the lowest premiums are state-run exchanges. This is quite a feat since “only 17 of 51 exchanges are state-run, so state-run exchanges are over-represented among the exchanges with the lowest average benchmark premiums.” (Norris, Para. 8). Although this is under Obamacare exchanges, it shows that state-run exchanges can effectively control the cost of premiums. A state that has efficiently and effectively controlled the health insurance markets is California. Through their state-run exchanges, California has managed to control the type and price of care provided by setting up a system that required all health insurers to provide the same deductibles and benefits within each of their coverage levels (Scheffler, Para. 7). Their plan is set up so that “insurers in all marketplaces must offer a defined set of “essential health benefits” in all plans and may offer plans at four coverage levels: platinum…followed in descending order of cost and coverage benefits by gold, silver, and bronze.”(Scheffler, Para. 7) With this system, California ensures that each of its providers offers equal health insurance plans that provide the same benefits and deductibles for the same price. Having states be in

In the tenth amendment of the constitution it says that the powers not delegated to the United States by the Constitution, nor prohibited by it to the States, are reserved to the States respectively, or to the people. The tenth amendment makes it clear that if a power is not given to the federal government, including the responsibility of running healthcare, it is not their job. Waldman, Para.2) The Founding Fathers put the tenth amendment in to protect against the federal government from obtaining too much power; however, “With the passage of the Health Care and Education Reconciliation Act, the federal government gave itself an incredible amount of power that inflicts burdensome regulations on individuals, corporations, and individual states.”(Hawkins, Para. 10). Constitutionally then, the responsibility to provide health care does not fall on the federal government but clearly lies with the states. Besides being unconstitutional, when Medicaid was first established in 1965, it was originally meant for the programs of Medicaid to be administered by the states, not the feds (Waldman, Para. 2). So not only is it constitutionally wrong for the federal government to control healthcare, but the Medicaid system we have is lawfully wrong according to the original document. While some might argue that since Washington pays for Medicaid for the