NJ Governor's Veto Leaves States with Health Insurance Exchange Authority at Thirteen

New Jersey Gov. Chris Christie vetoed a bill that would have set up a health insurance exchange as required by the Affordable Care Act. In his veto message, Christie advocated that the state wait until the Supreme Court has ruled on the constitutionality of the ACA.

Christie’s action leaves the total number of states with legal authority to establish health insurance exchanges at thirteen.

According to the May 1, 2012, analysis of the Center on Budget and Policy Priorities, ten states and the District of Columbia have enacted bills to create a health insurance exchange and governors in N.Y. and R.I. have issued executive orders to do so. Massachusetts already has a similar mechanism – the MA Connector – established in 2006 as part of a statewide health reform.

Source: Center on Budget and Policy Priorities

Health insurance exchanges are marketplaces for small businesses and uninsured persons to compare and purchase health insurance. Subsidies will be available to low-income individuals to make coverage affordable. Current ACA provisions require that states have in place the structure for a health insurance exchange by Jan. 1, 2013 and fully operate the exchange by Jan. 1, 2014. If a state cannot meet the requirement or chooses not to operate an exchange the federal government will do so in that state.

"While I appreciate the Legislature’s attempt to find steady policy footing in these shifting legal sands, I am concerned that a hastily created exchange in New Jersey will impose unnecessary obligations upon the state’s citizens," Christie said in his veto message. "I believe the better course of action ... is to continue to monitor the ever-changing landscape surrounding the implementation of the Affordable Care Act, and to refrain from imposing its mandates upon our citizens until outstanding issues are settled."

New Jersey has received $8.7 million in federal funding to begin planning for a state health insurance exchange.

Gov. Christie is the second governor this year to veto a health insurance exchange bill according to the New York Times. Gov. Susana Martinez of New Mexico did so earlier this year. Other governors are moving forward to create health insurance exchanges. Bills failed in 12 states.

New York Gov. Andrew Cuomo established a health insurance exchange by executive order on April 12, 2012. Kentucky Gov. Steve Beshear is reported by the Associated Press to be readying an executive order to create a statewide health insurance exchange, but only if the federal health reform act is upheld by the Supreme Court.