Jeffrey Hess, Mississippi Public Broadcasting, Author at �鶹Ů�� Health News

Finding Health Insurance For 71 Cents Per Month

Jeffrey Hess, Mississippi Public Broadcasting — Thu, 02 Jan 2014 10:38:05 +0000

If you’re looking for evidence that healthcare.gov, the federal health insurance marketplace, is working much better these days, you might want to ask Arlene Wilson.

The federal government has allocated $2 billion to Oregon to test ideas for coordinating care given by doctors, nurses, and hospitals. Now, the state has to figure out how it will measure its success

The 56-year-old is a chef with a popular pizza shop in Jackson, Mississippi.

Wilson says that “most jobs don’t offer” health insurance. Because “most of us live paycheck to paycheck,” she says she’s been unable to afford insurance for the past eight years.

But the health law was designed to help people like Wilson and her co-workers.

Aided by insurance navigator Gloria Shields, Wilson ventured through the online enrollment process. It took two hours, but: “I got the premium plan. Which pays up to 90 percent [of medical costs].”

Just as important, she received a subsidy – a tax credit of $711 per month. “So the only thing I have to pay a month is 71 cents. Less than a dollar,” she says.

Wilson’s plan is so inexpensive because she makes less than 17-thousand dollars a year and the premiums are reduced by federal subsidies tied to her income.

About 275-thousand uninsured Mississippians are eligible for the health insurance exchange and, like Wilson, they are slowly signing up for new plans.

But only two insurance companies are offering plans in the state and they only overlap in four of the state’s 82 counties. About 20 percent of Mississippians only have the choice of one company’s plans.

One of the companies, Humana, launched a late-December ad campaign to drive more people to the site according to spokesman Mitch Lubitz.

“There has been a ramp up as the healthcare.gov has gotten easier to use and there have been other options for people to go on and get information and enroll.” Lubitz says.

Mississippi’s Insurance commissioner Mike Chaney acknowledges the improvements in the enrollment process but is still skeptical that enough people will sign up for rates to be stable.

“From a zero to ten I would give it a confidence level of about a three. That is still not very good, but it is better than the one I was at the week before last,” he says.

Chaney says the unofficial count is around two-thousand people enrolled as of the middle of December but he says if trends continue to improve his confidence will rise to a five.

This story is part of a collaboration that includes , and KHN.

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Obamacare Outreach Is On Wheels In Mississippi

Jeffrey Hess, Mississippi Public Broadcasting — Wed, 04 Dec 2013 14:24:04 +0000

In Mississippi, as in the 35 other states where healthcare.gov is running the enrollment show, it hasn’t been easy to sign up for the health law’s new insurance options. That’s a political problem for Democrats and a personal problem for the uninsured — but it’s a business problem for the companies that are trying to sell insurance plans in the new marketplace.

One insurance company, Humana, is taking to the road to tackle the problem. Humana launched two specially equipped buses that have Internet access and insurance agents on board who can enroll Mississippians in Affordable Care Act plans.

Standing beside one bus, Humana’s Stacey Carter says the goal is to generate grassroots interest in the marketplace.

“We will be at Wal-Marts. At some CVS’s in the first quarter. We will be at gas stations. So it is really kind of what that community felt would be a good place to visit. And we are working on some churches as well,” Carter said, during an interview in late November.

Carter says people are enrolling as the website improves. Humana is selling insurance plans throughout the state of Mississippi. In 36 counties, it is the only company selling plans. Though the company is selling in 13 other states, it is running the buses only in Mississippi.

Lonnie Ross, uninsured with a wife and three children, is finally getting a chance to look at the prices and plans he can purchase on the exchange. Ross says after 15 years of being without insurance, he was surprised at his options. “Oh, I was very impressed. I am kind of excited. So I hope it works out,” Ross says. “I hope it is what they say. I am right in my range $150 to $200 (a month).”

At a Humana bus stop in Natchez, Marie Dillon found out that she can qualify for insurance that will cover the medicine for her chronic lung condition, which she has skipped for the last year. “I am excited about it. I feel like I can afford health insurance now. At one time I couldn’t. Just based on my medical condition, they wanted over $500 a month to get medical insurance. But with this it is going to cost me anywhere between $25 and $50 bucks a month,” Dillon said.

But the access to plan information is also bringing startling news to some of the state’s poorest residents. They are being left without any help to purchase insurance because they make too little to qualify for subsidies to buy private insurance, and do not qualify for Medicaid because the state chose not to expand eligibility for the program.

While enrollment runs through the end of March, people must sign up by Dec. 23 to get plans that kick in at the start of the year.

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Mississippi Consumers Try And Try Again To Use Healthcare.gov

Jeffrey Hess, Mississippi Public Broadcasting — Fri, 11 Oct 2013 06:14:00 +0000

JACKSON, Miss. – In Mississippi, one of 36 states letting the federal government operate the online health insurance marketplace created by the health law, consumers continue to face long delays and other technical difficulties as they try to log on and shop for affordable coverage. Sixteen other states and the District of Columbia are operating their own marketplaces.

“Why keep trying?” asked Meredith Stark, 29, a hotel desk clerk in the northeast Mississippi town of Blue Springs. “Because this is something we need. We have a right to life, liberty and pursuit of happiness. And, I am sorry, but not having health insurance denies life.”

Stark says she has a chronic blood condition and had been skipping medication for three years while uninsured because of its cost.

The marketplace, also known as an exchange, will offer plans based on four categories — gold, silver, bronze and platinum — with varying deductible costs, copayments and other consumer cost sharing. But the combination of heavy traffic – federal officials reports hits in the millions — and programming problems has made the web site difficult to access since its Oct. 1 launch.

After a week of trying, though, Stark managed to complete the online process and enroll her husband and herself in a plan that will cost $60 a month.

But other Mississippi residents report a very different story.

Robbie Gowdy, a 25-year-old uninsured bartender in Jackson, says he wants to enroll but when he attempted to use the site he found repeated errors, redundant requests for information, and long waits. He tried to use the website, but after an hour, he called it quits.

Jackson bartender Robbie Gowdy wants to sign up for health insurance, but has not yet enrolled (Photo by Jeffrey Hess/MPB).

“Usually when you have to jump through this many hoops you are at least going to have cable at the end,” Gowdy said. But he also plans to keep on trying.

“We got a little bit of the way, it wasn’t complete and total failure,” he explained. “I did get an account created in the marketplace. So that door is open for coming back later when the site is up and running more fluidly to see what kind of health coverage I am able to get.”

Officials need healthy young people like Gowdy to be persistent – if only people with serious health problems end up buying coverage, premium costs are likely to skyrocket in the marketplace in subsequent years.

The website is expected to be a main way the roughly 275,000 uninsured people in Mississippi get coverage. People who don’t have access to a computer or email account, though, will likely have to rely on the help of “navigators,” who can offer face to face help to enroll in the exchange. Currently there are around 50 navigators in Mississippi.

This story is part of a collaboration that includes , and Kaiser Health News.

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Mississippi Dems: We Were ‘Bamboozled’ On Medicaid

Jeffrey Hess, Mississippi Public Broadcasting — Sat, 29 Jun 2013 22:34:36 +0000

With just two days to spare, and with plenty of political drama, Mississippi lawmakers approved a plan late Friday to renew Medicaid for another year.

The joint federal-state program, which provides health insurance to some 700,000 poor Mississippians, was set to expire Sunday night.

Democrats had pushed hard to expand coverage to 300,000 more people, under a provision of the federal health law.

Republicans, including Gov. Phil Bryant, opposed the expansion, saying it would be too expensive, while Democrats countered that the federal government would pick up the tab for the new recipients. The partisan divide over Medicaid expansion led to lawmakers finishing their regular session in April without a plan to keep Medicaid running past the end of this month.

Bryant reacted to the approval of the existing Medicaid program with satisfaction.

“We needed to move, and I felt it had done everything we had accomplished. So I am very proud of it,” he said. “Special sessions are something I will be very frugal with in the future. But this obviously had to be done.”

While the GOP dominates Mississippi’s House and Senate, they needed a super majority – which includes votes from Democrats – to authorize the $400 million in taxes to fund the state’s share of the program. A last-minute legislative maneuver in the Senate left Democrats feeling as if they had no choice but to give up their expansion dreams for a year.

“I think we have been snookered,” said Democratic Rep. Cecil Brown, “This was simply a political stunt by our Senate to force something down our throats and stick a finger in the eye of the governor of the state of Mississippi. I don’t care who the governor is, he doesn’t deserve that.”

Next Year, Same Drill?

While the final vote was overwhelmingly in favor of renewing Medicaid for another year, Democrats are expecting another expansion fight during the next legislative session. House Minority Leader Bobby Moak warned his colleagues to learn from this experience.

“I have been part of bamboozling the other chamber a lot, and I don’t like getting bamboozled. So I think we need to work a little bit together next time and make sure you are not on the receiving end of the bamboozle stick,” Moak said.

Advocates for Medicaid expansion also sent out a barrage of statements expressing disappointment with the outcome. The Mississippi Health Advocacy Program called the decision shortsighted and political.

“Given that 59 percent of Mississippians support Medicaid expansion, it is unfortunate that many of our legislators ignored both the will of the people and the needs of those that out them in office,” the statement read.

Republicans were equally adamant.

“We’ve got 700,000 of our people on it right now. To increase to 300,000 more … and the federal government can tell you all they want that they are going to give you free money. It costs somebody. It costs somebody. I just don’t want Mississippi to be a part of the train wreck,” said the Senate’s number two Republican, Terry Brown.

The taxes that support the program are set to expire next year, likely setting up another round of debate and potential showdown over Medicaid and the expansion issue.

This story is part of a collaboration that includes , and Kaiser Health News.

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Political Fight Jeopardizes Mississippi’s Entire Medicaid Program

Jeffrey Hess, Mississippi Public Broadcasting — Sat, 22 Jun 2013 10:20:00 +0000

Medicaid and controversy are welded together in many states lately, but for the most part, the wrangling is about “new” Medicaid — the Obamacare expansion of the health program for the poor and disabled. Mississippi, though, is raising the stakes.

Gov. Phil Bryant photo by Lance Cheung/USDA via Flickr

Democrats and Republicans in the state are in a game of political chicken that could threaten the very existence of the entire Medicaid program by the end of the month.

More than 700,000 Mississippians get Medicaid, with the federal government paying about three-quarters of the cost, and the state picking up the rest of the tab. The Affordable Care Act calls for expanding Medicaid to roughly 300,000 more low income Mississippians. But initially, the federal government would pay the entire bill, and after a few years, the state would finance 10 percent.

When the U.S. Supreme Court made the expansion of Medicaid optional for states last year, Republicans in Mississippi, led by , adamantly refused to expand.

‘I do not believe that the federal government has the revenue to fully fund Medicaid across the United States of America,” Bryant said. “I am not going to fall into this trap and leave the taxpayers of Mississippi holding the bill.”

Democrats pushed back and made Medicaid expansion a legislative priority.

“What it boils down to in the end is that we are going to make sure that all Mississippians regardless of race can get the health care they deserve and that the federal government now says can be afforded to them,” said , who chairs the legislative black caucus, one of the most vocal pro-expansion groups.

Democrats are in the minority in Mississippi’s House and Senate and to pressure the Republicans to at least debate expansion, Democrats refused to vote on renewing Medicaid. Without a reauthorization vote by the legislature, Medicaid in Mississippi expires July 1. The legislature adjourned its regular session in April.

Republican did not allow a debate because he sees it as a waste of time. He and other Republicans are furious about the Democrats’ tactics.

“I am dealing with reality. The reality is that an expansion bill is not going to pass the House of Representatives,” said Gunn. “I think they are playing politics and we are dealing with reality.”

But Democrats say the reality is that about , and Democratic says that is a huge issue for patients and providers.

“If Medicaid went away in the state of Mississippi, the only people that would survive medically are the freaking plastic surgeons. Every other Medical function would go to hell in hand basket,” said Holland.

This is not the first time that Medicaid has been a political football in Mississippi. For all the heated debate, Republican says his colleagues on both sides of the aisle admit Medicaid will most likely be renewed. But sometimes it comes down to the 11^th hour.

“I don’t think there is any chance whatsoever that the division of Medicaid in Mississippi will cease to exist,” Burton said. “We will come back and we will reauthorize Medicaid and we will fund Medicaid and we will have a bill and a budget bill before July 1, I believe.”

It is widely expected that the governor will call lawmakers back next week for a special session. Democrats, despite their insistence that Medicaid expansion must happen in Mississippi say all they really want is a debate and an up or down vote. It’s something that has not happened yet, says Democratic minority leader Bobby Moak.

“[It’s the] same thing that legislatures all over the United States are debating right now in their chambers,” says Moak. “We have not had an opportunity to debate that. Yes, we need to come back and we need to debate that issue.”

Still, there is a chance that lawmakers won’t be called back or that they won’t agree.

In that case, the governor says he will run Medicaid by executive order without any legislative action. But it is unclear if that is legal.

This piece is part of a collaboration that includes , , and Kaiser Health News.

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Miss. To Require Cord Blood Testing On Babies Born To Some Teenage Moms

Jeffrey Hess, Mississippi Public Broadcasting — Mon, 03 Jun 2013 17:32:58 +0000

Mississippi lawmakers have embarked on a novel campaign to discourage older men from having sex with teenagers: Starting July 1 doctors and midwives will be required to take umbilical cord blood samples from babies born to some women under the age of 16 so officials can try to identify the father through a match from the state’s DNA database.

Miss. Gov. Phil Bryant

“It is our hope that we can deter men over the age of 21 from having sex, particularly with girls 16 years and younger, particularly if they know we are going to pursue them,” said who helped draft the bill.

Officials said Mississippi is the first state in the country to implement such a program.

, is also a supporter of the effort. Bryant, who was once a deputy sheriff, said it is necessary to protect young women who might be victimized by older men, even if the teenagers say they consented to having sex. Too many of these young teens are becoming pregnant against their will, he said.

“It is a tragedy that I think has been accepted over the years where people say the young girl agreed to it so we have to accept it. And that has got to stop,” he said.

State statutory rape law kicks in if the two people are more the three years in age difference, until the girl is 16, the age of consent in Mississippi.

The bill doesn’t explain who would prosecute the men if they are located and are believed to have broken the law, but prosecutors would have to determine in which county conception had occurred before charges could be filed. It also is not clear what age range prosecutors will target.

The law also doesn’t lay out who is going to pay for testing. Regulations about implementation are still being drafted.

, who drafted the bill, said one of his motivations is to find “who harmed that child” because these new mothers often refuse to name the father of their child.

The bill is a solution looking for a problem, according to Jamie Holcomb-Bardwell, director of programs for the , an advocacy and funding group on women’s issues. Few teen pregnancies involve very young girls and much older men, she said.

“It is a lot easier for politicians to talk about protecting young women then it is for them to talk about adequate sex education, access to contraception, looking at multi-generational poverty, making sure we have an adequately funded education system,” she said. “All of these things have been shown to decrease the teen pregnancy rate.”

While Mississippi’s teen pregnancy rate is about 60 percent above the national average, it is near a 40 year low. Of the 6,100 births to teenagers in 2012, 111 were babies born to girls under the age of 15.

Roughly 65-percent of teenage pregnancies in the state occur between teens who are one or two years apart in age difference.

The state medical association reluctantly accepted the law but insisted that lawmakers strip out a provision in the early version of the bill that included penalties for doctors who did not comply.

, a constitutional law professor at the Mississippi College school of law in Jackson, said the measure could raise a “hornet’s nest” of legal problems. “It is not at all clear that the legislature can deputize health care workers to collect evidence without a warrant,” he said.

This story is part of a collaboration that includes , and Kaiser Health News.

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Mississippi’s Lone Abortion Clinic Is Still Open And Still Controversial

Jeffrey Hess, Mississippi Public Broadcasting — Wed, 17 Apr 2013 09:59:05 +0000

Protesters clashed Tuesday outside the Jackson Women’s Health Organization, the only abortion clinic in Mississippi, which won a victory in federal court that allows the facility to continue to operate, at least for now.

The legal victory for the clinic came Monday when U.S. District Judge Daniel Jordan III temporarily blocked a state law that requires all the doctors at the facility to have admitting privileges at a local hospital. The judge is preventing the law from taking effect until a legal challenge against it is settled.

Outside the clinic in the state capital of Jackson, abortion rights supporters in yellow “clinic escort” vests helped women into the facility as anti-abortion protesters called to the patients begging them not to have the procedure.

The ruling is a big letdown for anti-abortion protestors like Cal Zastrow who wants to see the clinic closed. He compared abortions to the deaths caused by Monday’s attack at the Boston Marathon.

“I am very disheartened that some people feel they need to murder children with bombs and ball bearings and also with surgical abortion,” Zastrow said. “That is disheartening to me. That some people dehumanize other people and commit acts of terrorism on them.”

Supporters of the clinic played music and tried to shield the women from the shouts of the protesters.

Abortion rights supporter Drenda Hancock says she is energized by the ruling.

“I was actually here when we found out. Posted it the minute we got home. It is fantastic. I am thrilled. We are having a party see? It is great,” Hancock said.

The clinic was facing a Thursday hearing which would have likely resulted in the state pulling its license, since not all the clinic doctors were able to get admitting privileges. That hearing is now canceled.

In his ruling, Jordan wrote, “The State has plainly informed the Clinic that it will be closed pursuant to a statue that appears to fail the undue-burden test … considering this, and the other articulated and unrebutted harms, the Court concludes that the irreparable injuries alleged are sufficiently imminent to justify preliminary injunctive relief at this time.”

Clinic ownership has said repeatedly that every hospital in the area has rejected, or ignored, their requests for admitting privileges.

The , a national organization, filed a lawsuit against the admitting privileges law claiming it is an unconstitutional attempt to ban abortion. The law is on hold while the suit challenging it goes forward.

The law’s author, state , R-McComb, says he is not sure what the state’s next step will be.

“The governor feels very strongly about this piece of legislation. So we will just have to see over the next couple days what happens next,” Mims said.

The main lawyer for the clinic is less uncertain. Michelle Movahed with the Center for Reproductive Rights expects a permanent ruling within a month.

“The Supreme Court precedent is pretty clear here. And I think what the judge did is apply what the Supreme Court has said over and over and over. Which is that states can’t functionally block women’s access to abortion care,” Movahed said.

It is not clear when the next court date for the lawsuit against the state law will be. Until then, the clinic is allowed to remain open.

This story is part of a collaboration that includes , and Kaiser Health News.

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Mississippi Legislature Passes ‘Anti-Bloomberg’ Bill

Jeffrey Hess, Mississippi Public Broadcasting — Mon, 11 Mar 2013 22:00:03 +0000

Mayor Mike and his public health edicts are having a rough ride. On Monday, a state judge in Manhattan the rule capping soda sizes that Mayor Michael Bloomberg championed. (Here’s .) Lawmakers in Mississippi are taking things one step further.

A bill on the governor’s desk would bar counties and towns from enacting rules that require calorie counts to be posted, that cap portion sizes, or that keep toys out of kids’ meals. “” garnered wide bipartisan support in both chambers of the legislature in Mississippi, the state with the highest rate of obesity in the nation.

The bill is expected to be signed by Gov. Phil Bryant, a Republican. It was the subject of intense lobbying by groups including the restaurant association, the small business and beverage group and the chicken farmers’ lobby.

Mike Cashion, executive director the Mississippi Hospitality and Restaurant Association, says the bill is a direct reaction to Bloomberg-style government intervention in public health.

“If you look at how menus have changed, whether it be in fast food or family dining, you are seeing more and more healthy options,” Cashion said. “Not because of legislative mandates or regulator mandates but because of consumer demand. Our industry has always been one to respond to the marketplace.”

Rep. Gregory Holloway, a Democrat, ushered the popular bill through the state House. He says the goal is to create consistency in nutrition laws across the state. “We don’t want local municipalities experimenting with labeling of food and any organic agenda. We want that authority to rest with the Legislature,” Holloway said.

But the measure does have detractors in Mississippi: local politicians who say it steps on an ideal Mississippians hold dear — the right to govern themselves.

Chip Johnson, mayor of Hernando, Miss., near the Tennessee border, is no fan of a soda ban, but he doesn’t like the anti-Bloomberg bill either.

Hernando has built biking and walking paths all over town and has received national attention for the work. Johnson bristles at the Legislature’s efforts to dictate what he can do in pursuit of a healthier community, including restricting the ability to put nutritional information on menus.

“You know what? If little Alligator, Mississippi, wanted to do that, that is up to the people that live there. It is not up to the state to tell the people at the local level what to do,” Johnson said. “They are using this to mask what the bill is really about, which is taking away home rule.”

Johnson says he resents that the measure even puts some restrictions on a town’s ability to zone where a restaurant can go.

Still, the bill passed the state Senate, 50-to-1, and the state House, 92-26.

This story is part of a collaboration that includes , and Kaiser Health News.

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HHS Denies Mississippi’s Bid To Run Its Own Exchange

Jeffrey Hess, Mississippi Public Broadcasting — Fri, 08 Feb 2013 13:16:12 +0000

Updated at 10:15 a.m.

Mississippi Insurance Commissioner Mike Chaney, who has been the driving force behind creating a state based exchange, got his answer from the feds Thursday: Sure can’t.

The U.S. Department of Health and Human Services rejected Mississippi’s plan Thursday afternoon, making Mississippi the only state to have its exchange blueprint nixed by the federal government. Instead, Mississippi will have a federal exchange like the more than two dozen other states that have balked at implementing the health law.

The decision follows more than a month of delay from the federal government over the future of Mississippi’s proposal to run its own exchange. Chaney propelled the effort forward even though Mississippi Gov. Phil Bryant opposed a state-based exchange.

“We have taken HHS and CCIO at face value that they would work with us, but I fear that we have been unable to trust them at this point. And Americans need to be able to trust their government. I feel that I have been betrayed at this point,” said during a news conference Thursday evening.

The federal government said the split between Chaney and Bryant is at the heart of the decision.

Chaney in Mississippi based on his authority to run the state’s high risk pool. One problem with that is it has nothing to do with Medicaid — only subsidized private insurance. The Affordable Care Act says that the exchanges have to be one-stop shops for both private insurance and Medicaid. As insurance commissioner, Chaney doesn’t have access to Mississippi’s complicated Medicaid enrollment processes.

Gov. Bryant sent letters to HHS expressing his opposition to state based exchanges and questioning the commissioner’s legal authority to run one. Chaney insisted he had the authority and was backed up in a ruling by the state’s Democratic attorney general.

In a statement, Bryant praised the ruling from the federal government.

Chaney answers reporters’ questions at a news conference Thursday (Photo by Jeffrey Hess/Mississippi Public Radio)

“I have said repeatedly that the health insurance exchanges mandated by Obamacare are not free-market exchanges. Instead, they are a portal to a massive and unaffordable new federal entitlement program. They trigger new taxes on businesses and will ultimately drive more people onto Medicaid rolls. I firmly maintain my position that Mississippi will not willfully implement a mechanism that will compromise our state’s financial stability,” Bryant said.

Mississippi would have been the only southern Republican-led state with a state based health insurance exchange. But a spokesman for HHS said it just wasn’t “feasible.”

“With the Governor’s refusal to work with us or the insurance commissioner, there is no way to coordinate strategy with other agencies that he’s in charge of,” an HHS spokesman told KHN.

Commissioner Chaney predicts the federally run exchange will have disastrous consequences for the state insurance market.

“What you are going to see in the next 12 months is those premiums doubling, maybe tripling. You are going to see a 3.5% tax charged by the federal government for every policy sold on the exchange that the feds have,” Chaney said.

Chaney also suggested the decision to reject the blueprint came from the White House rather than from HHS, which is overseeing the exchange implementation.

Work has been underway on an insurance exchange for years and Chaney is not sure what of those efforts will be able to remain and what will be scrapped. The Web portal for the state’s exchange already exists at .

The commissioner is leaving the door open for Mississippi to run a state-based exchange exclusively for small businesses.

HHS wants Mississippi to consider a partnership exchange.

“Given the work the insurance department has done, Mississippi is an excellent candidate for a state partnership marketplace. We encourage Mississippi to apply to operate parts of its marketplace by the February 15, 2013 deadline,” the HHS spokesman said.

This story is part of a collaboration that includes ,�� and Kaiser Health News.

Phil Galewitz contributed to this report.

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Mississippi Builds Exchange Despite Objections Of Governor, Tea Party

Jeffrey Hess, Mississippi Public Broadcasting — Fri, 16 Nov 2012 11:13:17 +0000

The Mississippi Insurance Department officially told the federal government that it will run its own health insurance exchange and plans to file the exchange blueprint Friday.

If the state had not set up an insurance exchange, which is an online marketplace for comparison shopping for health insurance called for by the health overhaul law, the federal government would have done it instead.

Insurance Commissioner Mike Chaney says having Mississippi run the exchange gives the state control over what type of health insurance plans will be sold there.

“The history of the federal government has always been if they become the default operator of the program, they will spend massive amounts of money to implement a program. It may be on a different time line from that which is envisioned now, but it will be massive. It will be expensive. And it probably won’t work very well,” Chaney said.

Mississippi is one of the states leading the way toward an exchange, despite the and local tea party activists.

Laura VanOverschelde, with the , says she is not convinced that the federal government will take a hands-off approach.

“But they are in direct conflict with the socialistic program put out by the Obama administration. And they can try to push free market principals all they want to, and they are going to keep running into those road blocks. And those roadblocks are going to prove that the Obamacare can’t stand [in] the way it is written right now. It eventually will just collapse,” VanOverschelde said.

Members of the exchange board insist that state-level exchange operation is critical to making the market work.

Board member and insurance salesman Joel Jasper says it is important for the rules of the exchange to be set by Mississippians who have a clear understanding of the state’s market.

“Is the exchange free market? Absolutely, that is what we are talking about right here is how do you keep it free market. If you are not careful and you regulate it too much then who wants to participate?” Jasper said. “If it cost too much for a company to get involved in it, why get involved?”

The exchange website, , is already functioning and one company is currently selling very limited health insurance there.

When it is fully functional, insurance commissioner Chaney estimates that 10 or more companies could sell health coverage there.

Chaney he has through the state’s to establish the exchange. Byrant has said he in the state.

This story is part of a collaboration that includes ,�� and Kaiser Health News.

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