As the Affordable Care Act remains under the magnifying glass—debating on a repeal, replace, or fix—states are feeling the brunt of the confusion. States with the ways and means to create their own healthcare platform are doing just that, abiding by the mandates set forth by the ACA, but done in a way that works for them.
States like Massachusetts have RomneyCare, Hawaii with the Prepaid Health Care Act, and California with Covered California, which are all well-oiled systems that provide either qualified health coverage for residents or an exchange of their own. Alaska may soon be added to the list, as the state recently filed their application for an IRC Section 1332 State Innovation Waiver, which will grant the state permission to form their own health insurance marketplace.
These are beneficial options for many states, especially larger ones. However, are they great for all states? Should every state attempt to file an application for a State Innovation Waiver, the process could be long and cumbersome. Not to mention, as the ACA is still up in the air, this could complicate the process for many.
One option? Creating interstate compacts, where smaller states with a less thriving market can form treaties with bigger states that have already adopted their own healthcare platform. While the strength in numbers is still no match for the federal government, cutting costs, better bargaining, and stronger networks would arguably make for smoother healthcare systems.
A recent article by The Atlantic supports this option: “Interstate compacts allow individual states to maintain consistency in their laws by coordinating on a multistate level. While they may not rival the power of the federal government, compacts may be a next-best option for states facing sudden cutbacks in support from Washington, D.C.”
Are interstate compacts the way to go? Will healthcare providers then be available in more states, despite competitive markets? These are questions awaiting answers as states figure out how to maintain viable healthcare while Congress still determines its fate.