A letter sent Thursday to the Obama administration reiterates what Republican Gov. John Kasich told federal officials in November — that Ohio will keep its authority to regulate health plans in and out of the exchange, but leave running it to the federal government.
Exchanges can be run by the states, the federal government, or a state-federal partnership.
Consumers can get private health insurance, subsidized by the government, through the online health insurance marketplaces in each state. Small businesses will have access to their own exchanges. Open enrollment starts Oct. 1, and coverage takes effect Jan. 1, 2014.
The federal government initially instructed Ohio officials to submit a more detailed blueprint of its plan, which is required of those pursing a federal-state partnership. But recent conversations between officials clarified that Ohio no longer fit into that category.
Kasich told the Obama administration in a Nov. 16 letter that setting up a state-based exchange is too costly and states have little control over how to operate exchanges.
"Regardless of who runs an exchange, the end product is the same," he said at the time.
The state's letter on Thursday to Gary Cohen of the U.S. Department of Health and Human Services restates Ohio's intentions to let the federal government be responsible for the exchange.
Lt. Gov. Mary Taylor, who is also the director of the state's insurance department, stipulated in the letter that Ohio would have regulatory authority over the insurance business in Ohio as well as the capacity to oversee the certification of qualified health plans.
She said the department would continue to collect and analyze information on plan rates, covered benefits, and cost-sharing requirements. It would also ensure ongoing plan compliance and resolve consumer complaints.
"Continuing this regulation at the state level, as Ohio has done for decades, will preserve the high quality oversight of the industry for which Ohio is known, and also help provide stability to our state's insurance market at this time of considerable volatility," Taylor wrote.
Kasich has decided to proceed with another key part of Obama's law: expanding Medicaid coverage for more low-income Ohioans.