RIVERTON, Wyo. — The committee studying options for a Wyoming health insurance exchange voted Thursday to gather more information about state and regional programs.
The Wyoming Health Benefits Exchange Steering Committee asked a consultant to develop a cost model for a state-run program. The group also asked representatives of Public Consulting Group to identify other states that may want to participate in a regional exchange.
Insurance exchanges are marketplaces where small businesses and individuals can purchase health coverage. Advocates promote them as a way to address rising health care costs by giving consumers the ability to shop for different policies.
Exchanges are a key part of the Affordable Care Act, which requires each state to have a program in place by 2014. The exchange must be self-sustaining by the following year.
In order to meet the federal timeline, the committee must deliver its recommendations to state lawmakers by January. An interim report is due to lawmakers by October.
Committee members weren't ready to decide among a state, regional or federal model.
"We can examine a couple of options and try to come up with what we think is best for Wyoming, and then take it to Cheyenne and try to sell it," said state Sen. Bill Landen, R-Casper.
If state lawmakers decide not to establish an exchange, the federal government will administer a program for Wyoming. Thursday's vote didn't eliminate the federal option, although committee members have shown little interest in turning control over to Washington unless they determine the program isn't viable.
A state exchange would preserve Wyoming's decision-making authority, said Bob Parr of Professional Consulting Group.
"You are a fiercely independent group of folks, and it's my understanding that you'd like to keep it that way," he said.
But by going it alone, the state would be responsible for developing an economically viable program that's ready to enroll consumers by the fall of 2013.
The regional approach would allow Wyoming to share costs with other states, Parr said. However, the states would all have to agree on a way to govern the exchange, which might be difficult.
Committee member and state Rep. Elaine Harvey, R-Lovell, said she's discussed exchanges with lawmakers in Utah. She plans to talk with them again next month.
Harvey described Utah's exchange as a free-market, enterprise system. She said she would like to further examine a relationship with Utah, as well as the possibilities of a Wyoming-only exchange.
The Utah model does not comply with the federal health care overhaul, cautioned Christian Jones, another consultant with Public Consulting Group. If Wyoming pursued such a system, the federal government might start a second, compliant exchange in the state.
If the committee recommends pursuing an exchange, it will have to convince lawmakers suspicious of federal involvement in health care. A bill establishing the exchange would require a two-thirds majority to be introduced during the 2012 legislative budget session.
"I'm not sure of us getting anything through unless it is pretty lean, pretty self-sufficient, pretty defined including, and especially, the (program's) sustainability," Harvey said.
Lawmakers in only one state — Louisiana — have decided to let the federal government develop its exchange. Legislators in other states, such as Florida, have indicated they will likely follow suit.
The regional approach hasn't gained much traction among states either, Parr said. Agreements between states to share certain services — such as an exchange call center — are a more likely option.
The committee is scheduled to next meet Sept. 14 in Casper.