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On Exchanges: New Jersey Governor Faces Choice on Bill to Create State Exchange

By Rebecca Adams, CQ HealthBeat Associate Editor

October 12, 2012 --The New Jersey state legislature may soon send a bill creating a health benefits exchange to Republican Gov. Chris Christie, but the governor still plans to wait until well after the Nov. 6 elections to announce whether he'll sign it.

Christie vetoed an earlier version in May, in part because the Supreme Court had not yet ruled on the 2010 health care law (PL 111-148, PL 111-152). The governor also raised objections to some specifics in the earlier bill, such as $50,000 salaries for part-time exchange board members. The pay has been removed from the more recent version, which was passed by the state Senate. The legislation was approved by an Assembly committee last week and will next be voted on by the full Assembly, which is expected to back it.

But Christie has 45 days after a bill reaches his desk to decide whether to sign or veto it, said spokesman Kevin Roberts. And the governor is still undecided about what he will do.

States face a Nov. 16 deadline for submitting an application to the Department of Health and Human Services if they plan to operate their own state exchanges or state-federal partnerships.

"I won't make a decision until I have to," said Christie last week. "I don't have to make one until the 16th, so I want to make sure I'm as fully informed as I can be. That's ultimately our call. It's an executive branch call and we'll make the call."

Christie is facing a re-election contest himself next year. As he weighs whether to go along with the Democratic legislature on the exchange, he may be considering what the reactions of voters will be in the traditionally blue state. Christie also will have to decide whether or not to expand Medicaid as the health care law allows. He has criticized the idea of expansion but not said definitively that he would reject it.

New Jersey is one of several states that could decide to move ahead with their own exchanges after the elections if President Obama is re-elected.

Amanda Cowley, who deals with exchange implementation at the federal Center for Consumer Information and Insurance Oversight (CCIIO) said on Oct. 5 that the governors of 14 states already had sent in letters to HHS Secretary Kathleen Sebelius saying they will establish the exchanges.

State officials also can choose to create a partnership with the federal government or to allow the federal government to operate the marketplace.

The Kaiser Family Foundation, as of late September, had a tally of 16 states that have established state exchanges, three that were planning state-federal partnerships, eight have seen no significant action and eight have decided they won't create exchanges. Another 16 have seen some activity but are still studying their options before making a decision. Of those still considering their options, Minnesota is among the most prepared and capable of creating its own state exchange if state policy makers decide to do so. Democratic Gov. Mark Dayton appointed a Health Insurance Exchange Advisory Task Force last year that continues to meet and discuss regularly to discuss issues related to creating an exchange.

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