Ryan-Coburn, Wyden-Bennett and Other Animals New York Times (blog)
For such exchanges, leaving states free to decide whether they want to set them up or not. That’s a substantial difference, and one that partisans of federalism should appreciate.At the same time, however, the plain language of the bill strongly suggested that if states did set up the exchanges (and presumably there would be a great deal of soft pressure to do so), they would still be subject to two of the three regulatory pillars shared by Obamacare and Wyden-Bennett. There would be no individual mandates, but the states would have to impose some kind of guaranteed issue (“the Exchange would require all participating insurers to offer coverage to any individual—regardless of patient age or health history”), and any insurance package sold on the exchange would have to be “comprehensive” rather than simply catastrophic (“plans offering coverage through an Exchange would have to meet the same regulatory standard used for the health benefits given to members of Congress”).
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