The Affordable Care Act is here to stay now that President Obama is re-elected, and while health exchanges are key components required for each state under the law, what are the implications for Missouri now that Proposition E has passed?

The federal law has given all states the choice to set up their own health exchange or have the federal government set up the exchange. However, the deadline for the state to submit a health insurance proposal under Proposition E is Friday. Because Missouri didn’t pass the right legislation and the state stopped working on it, they won’t be able to meet the deadline.

The deadline has now been extended to mid-December. Governor Nixon’s blueprint for the state exchange will be a federal one, at least for the first year.

Missouri Foundation for Health policy analyst Thomas McAuliffe says December 13th is prior to the meeting of the state legislature and the state legislature does not convene until January. “So I believe that Governor Nixon’s administration is going to tell the federal government that we cannot set up an exchange and we want it to be fully federal based,” he says.

McAuliffe says every year the state will have an opportunity to take over the exchange from the federal government, but the state has to show the federal government what they have done to make it possible for them to run it on their own.

“The state has thought about and even done some strategic planning for what a state-based exchange might look like, and the federal government doesn’t want to run 50 state-based exchanges,” he says.


AUDIO: Mary Farucci reports. (:59)