CHARLESTON, W.Va. --Gov. Earl Ray Tomblin is expected to scrap West Virginia's plans to establish a state-run health insurance exchange, a key component of President Obama's federal health-care law, according to public health advocates and state lawmakers.
Tomblin has until Friday to notify the U.S. Department of Health and Human Services whether West Virginia plans to pursue its own online health insurance marketplace for consumers -- or leave the program to the federal government.
The governor seems poised to decide against a state-operated insurance exchange, according to officials who have met with Tomblin aides about the program.
"There has been no indication from the administration they want to pursue a state-run program," said House Health Committee Chairman Don Perdue. "The federal government would set it up and run it for us. I have had no indication otherwise."
On Wednesday, Tomblin administration officials canceled an interview with the Gazette about the health insurance exchange. They would not confirm that Tomblin had decided against West Virginia designing its own health insurance program.
"The governor continues to evaluate all options available to him," said Amy Goodwin, a Tomblin spokeswoman.
Jeremiah Samples, a state Insurance Commission administrator assigned to set up the exchange, referred questions to the governor's office.
"There hasn't been a final decision yet as to what direction the state is going to take," Samples said.
Perdue and others said Tomblin's office plans to pursue a so-called "state-federal partnership insurance exchange" that would leave most of the program's heavy lifting to the feds. West Virginia would only play a minor role -- perhaps monitoring insurance companies that participate -- once the exchange was up and running.
"The partnership is heavily weighted to the federal government," Perdue said. "It's the same old story. We're taking the easy way out."
Tomblin's administration has spent thousands of man-hours and millions of dollars in federal grant money planning a state-operated exchange.
In April 2011, Tomblin signed legislation that established a "West Virginia Health Benefits Exchange" to be headed by a 10-member board of directors. Tomblin hasn't appointed any members.
"It's my understanding that they'll never be appointed," said Renate Pore, health policy analyst with the West Virginia Center on Budget & Policy in Charleston.
In June, the state solicited bids for the information technology required to run the online health insurance program. But Tomblin's office has held up the bid request in the state Purchasing Division, according to a report by the Kaiser Family Foundation.
Political observers say Tomblin would have faced a severe backlash from voters and attack ads from Republican gubernatorial candidate Bill Maloney, if the state had taken additional steps to implement the health insurance exchange, a key component of "Obamacare."
Politics aside, supporters of a state-run exchange said the federal government was poised to pump millions of dollars into West Virginia to set up the program.
"We could have controlled our own destiny," Pore said. "It's a missed opportunity."
Last week, the federal government notified states that they would have an extra month - until Dec. 16 -- to deliver detailed plans for state-run health insurance exchanges, if they decided by Friday, Nov. 16 to go that route.
Even if Tomblin's office changed direction and decided to establish a state-operated insurance program, West Virginia likely wouldn't have time to develop a comprehensive blueprint for the exchange in 30 days because the project's preliminary planning stalled during the gubernatorial campaign.
"It's my understanding we will not do a state-level exchange," said Perry Bryant, executive director of West Virginians for Affordable Health Care, a group that meets regularly with Samples' office.
Many larger states, including California and Colorado, plan to run their own health exchanges, while states such as Missouri and Kansas have decided to let the federal government handle the program. Arkansas, Delaware and Illinois have already announced plans to set up state-federal partnership exchanges.
President Obama has said health insurance exchanges will establish a "one-stop shop" for consumers searching for an affordable health-care plan. Individuals will be able to buy health insurance, subsidized by the federal government, from private insurance companies. The online exchanges will allow consumers and businesses with up to 100 employees to compare benefits and prices, starting in 2014.
Though he preferred a state-run program, Perdue said the state-federal partnership was a step in the right direction for expanding health coverage in West Virginia. The state has until Feb. 15 to submit detailed plans about the partnership exchange to the federal government.
"It's always better to be driving the bus, rather than riding the bus, but you're still going to get to your destination safely," Perdue said. "In this case, we're going to be the passengers."
Reach Eric Eyre at erice...@wvgazette.com or 304-348-4869.



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