Impeding changes to our Health Care system

[TheMercenary]

On exchanges:

But while House and Senate lawmakers envision the exchanges performing similar functions, there are some key differences.

For example, not everyone will be able to use the exchanges. In both bills, at least at first, only individuals who don't have access to insurance at work and small businesses could buy coverage through the exchanges. But while the House bill might open up the exchanges to more people and larger firms later on, the Senate bill would not.

Another very big difference is that in the House bill, the exchange would be national, set up and run by the federal government. In the Senate bill, each state will have to set up its own exchange, complete with its own state law on the subject.

Liberals tend to support the House's national approach; moderates, the insurance industry and the state insurance commissioners prefer the Senate approach that gives each state responsibility for its own exchange.

Jost worries about the Senate's approach: "It seems to me to be a much more complicated process that has a lot more room for failure and, frankly, I think a lot less accountability," he says. "Because if the state fails to do it, then the federal government is supposed to step in, but I think it's going to be difficult.

http://www.npr.org/templates/story/s...ryId=122476051