On the heels of the landmark ruling by the United States Supreme Court on the Patient Protection and Affordable Care Act of 2010, or what is better known as Obamacare, many of the states challenging the legislation are now pushing back, refusing to implement the Health Insurance Exchanges as mandated by federal law come January 2014. Mississippi, however, is not one of those states.

Conservatives across the Magnolia State are asking questions and demanding answers on why this red state, where the majority of the population is sure to be more than a little apprehensive on implementing anything attached to Obama, would be rushing head long with such plans.

Republican Insurance Commissioner Mike Chaney recently told NPR, “It is important that we have an exchange that is designed by Mississippians. Operated by Mississippians. For Mississippians…We don’t want an exchange from the federal government that is one size fits all. What may work in New York state may not work in the state of Mississippi.”

Chaney is referring to the fact that the health reform law mandates that either the states enact their own exchanges or a federal version of the exchange by 2014.

The Commissioner also referenced legislation in Mississippi that was drafted by Republican Senator Buck Clarke, passed by the legislature and signed into law in 2010 by then Governor Haley Barbour, who has long been a proponent of Health Insurance Exchanges. This action established the Health Insurance Exchange Study Committee (SB 2554) which Chaney says allowed him to move forward on the plans to enact the exchanges.

The life of this legislation was supposed to last only a year, giving the committee time to make a report to the legislature in 2011, but it was reauthorized that same year (HB 377) allowing the committee to continue its work.

Chaney also told NPR, “It appears that I am swimming upstream against the trend of other southern states but here is the problem: other southern states did not have in place the statutory law that I had in place.”

According to the Center for Mississippi Health Policy, Mississippi has received some $333,000 in federal monies for the Consumer Assistance Program in September 2010. The Mississippi Insurance Department also received $1 million in federal funds for a State Planning Grant. The state was also awarded $20 million from the federal government in the form of an Affordable Insurance Exchange Establishment Grant to allow Mississippi to continue its work toward full implementation and compliance with the Obamacare mandate.

In the midst of all of this activity and political wrangling, in May 2011, the Mississippi Comprehensive Health Insurance Risk Pool Association adopted a resolution and amended its bylaws to establish and administer Mississippi’s Health Insurance Exchange. The inaugural meeting of the Mississippi Health Insurance Exchange Advisory Board was held in January 2012. And on March 30, 2012, Republican Governor Phil Bryant signed SB 2589, which redefined the number and requirements for the Association’s Board of Directors, allowing the entity to continue its work.

According to The Henry J. Kaiser Family Foundation:

“In a Request for Proposals (RFP) released on May 22, 2012, the Risk Pool Association described a strategy to develop and implement the Exchange exclusively using outsourced services with a multi-phased approach. The first phase focused on creating the web portal with shop and compare functionality, with the RFP for this task already awarded. Phase 2 focuses on Exchange functionality for unsubsidized Qualified Health Plans (QHPs), specifically the plan and premium calculation data that will enable consumers to shop, compare, and enroll in a carrier’s plan through the Exchange portal. This phase will also include marketing and outreach, navigator, call center, and other services necessary to support non-subsidized Exchange functions. Phase 3 includes most plan management, eligibility, and enrollment functionality. The selected vendor for this RFP will coordinate with the Mississippi Division of Medicaid, which continues to be responsible for eligibility determination services for Medicaid and the Children’s Health Insurance Program (CHIP). The fourth and final phase is for other supportive services and may be procured together or as a series of individual procurements.”

The Foundation also reports:

“On May 23, 2012, the Insurance Department released an RFP to develop a statewide community outreach strategy and implement a campaign to inform state residents about the Exchange. Services for this contract will be awarded to a single vendor and executed in two phases. RFP submissions were due on June 13, 2012. The first phase extends from July 15 to August 14, 2012, and focuses on a comprehensive pre-operational public awareness plan. The second phase will begin on August 15, 2012, and end on December 31, 2013, depending on availability of federal funds. This second phase will be the Exchange implementation educational plan.”

All of this leads us to today’s meeting of the Mississippi Health Insurance Exchange Advisory Board.

The Mississippi Tea Party appeared at the meeting and urged Chaney and the board to stop the implementation of the exchanges with the ultimate goal of stopping the implementation of Obamacare in the state.

Chaney contended that not proceeding with the implementation of the exchanges will mean less control by Mississippi.

Yall Politics sought comment from Governor Bryant on the issue. Bryant’s Communications Director Mick Bullock replied stating, “Governor Bryant supports a free-market based method of delivering health insurance products
to consumers and he is committed to ensuring that the health insurance market remains competitive and accessible to individuals and employers in Mississippi.”

This does not say whether or not Bryant will seek to reign in these exchanges given the Supreme Court’s ruling on Obamacare and the subsequent outcry by conservatives around the country, especially here in his own state.

However, Bryant is also engaged in a lawsuit against the health reform law saying that the federal government cannot force Americans to disclose medical information to an insurer since it violates the right privacy. This piece of the puzzle is set to be tried this October in Hattiesburg.

My guess is that Mississippi is simply too far down the road not to implement some form of a Health Insurance Exchange given the federal dollars the state has already received, and Bryant, Chaney and most in the legislature know it.

But given the disdain for the PPACA, it’s as if the state is proceeding down both roads to ensure the utmost self-control while fighting for the demise of the reform.

This saga should also be a good reminder for Mississippians that whenever you take federal dollars, there are always strings attached.

As it stands today, there is still much explaining to do on this one and the dialogue needs to begin in earnest soon so the people of Mississippi understand the moving parts of this effort, an effort most conservatives remain overwhelmingly apprehensive about given the national dialogue.