A key aspect of Obamacare is its mandate for health insurance. To make finding coverage easier, beginning in 2014, consumers and businesses will be able to shop for and compare insurance plans on websites known as “exchanges.

States can set up their own exchange, putting them in control of key decisions such as which insurance plans are offered and what they must cover. States can also opt out and let the federal government make all the decisions. A third option exists for a state-federal hybrid. Today was the deadline for states to indicate whether they would run a state-based exchange, with blueprints due by mid-December for their implementation. States wishing to partner with the federal government on a hybrid have until February 15 to submit the blueprint.

Today, all eyes were on the Kasich administration to see what they would choose.

Tea party types want absolutely nothing to do with Obamacare, strenuously opposing a state-run exchange as an endorsement of the law. The Ohio Liberty Coalition yesterday reminded Kasich that in 2010, he made a campaign promise to “block Obamacare.” The 1851 Center has promised to sue the state if it opts for a state-run exchange.

Meanwhile, more moderate voices in the Republican coalition — namely the business community, in particular the state’s insurance industry — have argued for a state-run exchange, which would ensure that Ohio could establish rules that will benefit Ohio’s homegrown insurance companies and, in turn, the 400,000 Ohioans they employ.

Today, Kasich tried to have it both ways. His website carries the following banner:

He tweeted that he had “said no” to a state-run exchange:

He even put a video on his campaign website featuring Mary Taylor explaining why they left the exchange “to the federal government.”

But that’s not what happened. If you read the announcement closely, and know what to look for, what Kasich actually opted for is the hybrid state-federal model in which the federal government does the heavy lifting but works in close partnership with the state who helps to establish the rules of the road. A big clue comes at the end of the statement when they say “Ohio will inform the federal government of its plan for preserving these rights early next year.”

It gets clearer if you were lucky enough to get the following clarification from spokesperson Rob Nichols, which arrived in inboxes of some in Ohio’s business community today:

This morning, Gov. Kasich informed the U.S. Department of Health and Human Services that Ohio will not run an Obamacare health insurance exchange but will leave that to the federal government.  Also, he informed HHS that Ohio will retain regulatory control over health insurance plans offered through a federally-operated exchange as well as retain the authority to determine who is eligible for Medicaid benefits. The Administration will submit additional details to the federal government prior to HHS’s February 14 deadline.

See that last line? The February deadline (it’s actually the 15th) refers to the date HHS has given states to provide a blueprint for a hybrid state-federal exchange partnership. States opting for a purely federally-run exchange don’t have to submit a blueprint. Ohio is going in on Obamacare implementation in partnership with the federal government, despite the impression they are trying to give to their right wing.

It’s hardly the hands-off approach desired by the tea party.

Kasich and Taylor don’t want to upset their tea party supporters and let them know they are going to be willing and active partners in the creation of a hybrid state-federal exchange, so they left those words out of all their public releases. At the same time, they needed the business community to know they hadn’t actually caved in to the crazies in their party and sent clarifications by email and made reassuring phone calls to ensure that, despite their public rhetoric about “saying no” they’d actually decided to join hands with the Obama administration to jointly launch an insurance exchange in Ohio.

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  • So the feds run the exchange but Ohio gets to set the rules? That sounds great. Don’t really get the tone of the article though – are you criticizing Kasich? Sounds to me like he made a reasonable decision.

  • dmoore2222

    This is the kind of dishonesty that led to republicans losing yet another election. The fact that they just can’t bring themselves to tell it like it is has created distrust among voters who have become much more aware of these deceptions. Perfect examples: Husted trying to call his voter supression tactics an attempt to have “consistency” and republicans in general claiming the economy was getting worse when it has been improving steadily for the past three years.

  • dmoore2222

    I think what he’s trying to say is that it is a deception to claim that the State of Ohio is rejecting an Obamacare health exchange when it is indeed participating. This is a lie, pure and simple. And people are tired of this nonstop political campaigning based on lies and half-truths. It seems that republicans’ greatest fear is that this will all work and they will be at a political disadvantage. Imagine that. Wanting something beneficial to fail just so the other party looks bad. Is this what we elect people to do?

  • Don’t ya’ love it when Kasich slips the weenie to the baggers and they are too stupid to realize it?

  • The author of this article is incorrect. A state run exchange does NOT give the state “…control of key decisions such as which insurance plans are offered and what they must cover.” The federal government controls EVERYTHING. Setting up a state-run exchange simply puts the state on the hook for all FUNDING!! The state-federal choice made by Kasich is nothing but a way of hiding his selling-out of the conservative Republican Party base. The federal government cannot commandeer a state so HHS has “cooked up” a
    so-called state-federal partnership as a way to get permission from the
    state to set up the HHS-run exchange in a state. States would provide an
    online “storefront” and HHS would run all exchange operations. This is
    their attempt to get state cooperation for the federal takeover.” Here is the link for the above quote. http://healthenews.cchfreedom.org/newsletter.php/41
    Ohio citizens must contact their spineless governor and let him know that he is fooling no one. THose still wondering why the New England liberal Willard Romney lost, here is a classic example. Republicans being too gutless to stand up to the left and selling-out conservatives and conservative principles.

  • Foraker

    Yes, Kasich is trying to hide his cooperation with the federal government, but this Obamacare supporter thinks that the hybrid approach is the best for our state. Good decision by the governor, bad public relations, as usual.

  • nowaRINO

    The regulator get the campaign cash from the insurance industry, it’s just that simple.

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