Even as Virginia's Republican leaders wage political war on President Obama's health care reforms, state officials are working with the administration to get ready for the law's implementation should the Supreme Court declare it constitutional.
Obama this week handed down a lengthy blueprint for states to set up health insurance exchanges so uninsured individuals and small businesses can buy health care coverage from competing insurance companies. Virginia is one of several states opting to delay creating such an exchange until June, after the high court is expected to rule on a legal challenge filed against the reforms by several states. Virginia also challenged the law but the Supreme Court didn't take it up.
Nothing in the blueprint Obama sent down this week was surprising or enticed the state to formally set up an exchange, said Secretary of Health and Human Resources Bill Hazel. Virginia Gov. Bob McDonnell immediately blasted the Democratic president's "inability to provide critical guidance to their broken health care reform mandate," including what benefits must be covered.
States that choose not to set up their own exchanges would instead join a federal exchange that has yet to be defined. Virginia officials would prefer not to go that route and instead have worked behind the scenes, sometimes directly with the administration, to put the infrastructure in place for a state exchange, Hazel said.
Technically, states are required to have their own exchanges set up by March 23, the second anniversary of Obama signing his top legislative achievement. But federal administrators won't check for compliance until the start of next year.
If the Supreme Court upholds the reforms, the General Assembly would have to meet in special session to approve McDonnell's proposal for an exchange.
The Obama administration has indicated to Hazel they intend to let some deadlines slide to give states more time. In a Tuesday meeting with representatives from Washington, Hazel suggested "to think about working with Congress to slow this train down a bit," he said.
Democrats, and even some Republicans, were pushing to have Virginia set up its own insurance exchange, proposing legislation this spring that would have set up a quasi-government agency to oversee implementation of an exchange. But Republican leadership, with encouragement from McDonnell, opted to put off action.
"He's running out of time," said Del. Jennifer McClellan, D-Richmond. "It's purely political."