Letter: Louisiana needs an exchange

In his first interview after the November elections, Gov. Bobby Jindal called for an end to what he called “dumbed-down conservatism” and “bumper-sticker slogans,” and instead, for serious solutions to our pressing challenges. I could not agree more. But when it comes to health reform in Louisiana, the governor has yet to heed his own advice. He is about to squander an opportunity to reduce health insurance premiums, strengthen our economy by supporting businesses and health providers and provide access to care for Louisiana’s uninsured — all for the sake of ideology.

Most people agree that robust competition is necessary for an affordable and high-functioning health insurance market. Unfortunately, this does not exist in Louisiana. Our own insurance commissioner, who has said he supports state-based exchanges, recently called our health insurance market “noncompetitive.” When individuals, families and small businesses in Louisiana shop for health insurance, they have very limited options and it is expensive.

The Affordable Care Act helps address this problem by creating health insurance exchanges, a pro-market mechanism that was conceived by conservatives and has been supported by Republicans for years.

Exchanges function like health insurance malls, giving consumers multiple options to buy insurance, instead of just one or two. This encourages competition among insurers to provide the best product to attract customers. Exchanges also give small firms many of the advantages of large businesses by reducing the burden and cost of enrolling employees in small group plans. Following similar reforms in Massachusetts, health insurance premiums in the individual market dropped by as much as 40 percent.

But not every state is like Massachusetts, so under the Affordable Care Act each state has the opportunity to create its own state-run health exchange, uniquely tailored to the needs of its people. If, however, a state fails to act, the law requires the federal government to do so.

As a strong states-rights advocate, one would expect Gov. Jindal to jump at the chance not to cede control over Louisiana’s exchange to the federal government. But instead he refuses to engage, which will result in one-size-fits-all reforms that won’t reflect Louisiana’s unique needs.

I acknowledge that the Affordable Care Act, passed by Congress and upheld by the Supreme Court, may need some adjustments as we go along, and I stand willing to work with the governor on smart improvements. But as the governor said himself, “you can’t beat something with nothing.” He still has the chance to take his own words to heart and implement a health exchange for the people of Louisiana. The clock is ticking — I urge him to take this historic opportunity before Friday’s deadline. That is what the people of Louisiana need and deserve.

Mary Landrieu

U.S. senator

New Orleans

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