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For a state that has historically eschewed federal government “interference” in how it manages its affairs, Alabama has invited federal officials to protect its citizens. Alabama’s Gov. Robert Bentley sent a letter to federal health officials saying Washington — not Montgomery — will be responsible for making sure health insurance plans sold in the state comply with requirements such as covering people who have pre-existing medical conditions. So Alabama insurance regulators will not enforce the consumer protection provisions of the Affordable Care Act. I thought consumer protection was the job of state insurance regulators.

The governor had previously decided not to have Alabama set up its own health insurance exchange but rather to let the federal government run it. He now has also rejected the option of expanding the state’s Medicaid program to cover more low-income people. The consumer protection provisions are among the most popular and least controversial parts of the 2010 law. Some of those provisions keep insurers from imposing annual limits on benefits, allow young adults up to age 26 to receive coverage through their parents’ plan, and crack down on unreasonable premium rate increases. Can you imagine Alabama’s politicians not wanting consumers in the state to have some say in how these key provisions are to be enforced?

The Centers for Medicare & Medicaid Services will now be the enforcing entity for consumer protection under the Act. As Alicia Hartinger, a spokeswoman for CMS, stated recently “It is our strong preference that states continue to be the primary enforcers of the important consumer protections that are now federal law. To ensure that all consumers will benefit from these important consumer protections — like no denials for pre-existing conditions, no discrimination against women in setting premium rates and no arbitrary limits on coverage — CMS will step in to enforce these protections when necessary.”

It is an interesting twist for a state that has historically challenged the federal government’s right to enforce laws disagreeable to Alabama officials. There is something awry here- Alabama invites federal enforcement? Frankly, Alabama consumers may be better served by the federal government enforcement. Time will tell, but I am curious why Alabama has this aversion to protecting its citizens.

Defending Alabama’s position, Jennifer Ardis, a spokeswoman for Bentley, said Friday the governor consulted with state insurance officials and does not believe they have the authority to enforce the provisions. She also said the costs of enforcement are “unclear.” Does this mean politicians in 44 states have figured out how to do it, but politicians in Alabama cannot? Many states have passed new laws or regulations necessary to enforce the Affordable Health Care Act provisions. Are Alabama legislators afraid to do so? Afraid they may not get re-elected because they provided consumers protection under the Act? Apparently so.

In addition, Bentley also told federal health officials Alabama would not be involved in certifying which health plans qualify for the health insurance exchange, a new marketplace where consumers can comparison-shop for coverage from several different companies. Well, this is a great move in a state where Blue Cross Blue Shield is for all practical purposes the only health care insurer. With BCBS here there is no reason to allow consumers to have a choice?

Alabama State Senator Roger Bedford may have summed it up best: “Governor Bentley seems more interested in standing in the schoolhouse door over federal health care than he is in helping the people of Alabama, which is sad, considering he’s a physician.” Only time will tell whether Governor Bentley’’s decision will help the people of Alabama or not.

One Comment

  1. Gravatar for Ron Kimball

    One can certainly presume from your article you are a staunch Democrat. Are you trying to set yourself up for a run for political office?

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