In doing so, he set in motion the framework to establish a state-run health exchange. On Wednesday, in a post-election press briefing, McDonnell conceded that Virginia would not meet the Nov. 16 deadline for a blueprint for the state-run exchange and would default instead to a federally run insurance exchange. "The only logical decision is to choose the federal option," he said. "I don't have the answers for Virginia. They're telling us we have two years to build an exchange. It's expensive….I don't want to buy a pig-in-a-poke for Virginia taxpayers."
The Affordable Care Act mandates that each state have its own health benefits exchange by Jan. 1, 2014 to offer affordable insurance options to individuals whose employers don't offer health insurance and to small businesses. The insurance plans must include mandated minimum benefits and meet certain cost controls. Under the Affordable Care Act, the states have the option of running their own exchange, partnering with the federal government, or allowing the federal government to run the exchange for them. Sixteen states have already established their own.
In fall 2010, Virginia received a $1 million federal grant to jump-start a state exchange and the VHRI duly established task forces in six key areas, including
Though the VHRI report with its recommendations regarding the structure and governance of a state-run health benefit exchange was then submitted for consideration to the 2012
On Wednesday, McDonnell acknowledged that repeal was no longer realistic and that a state exchange would go into effect — but under federal auspices. He noted that the deadline for grants had been extended to October 2014, which would allow Virginia to see how the exchange worked under federal control first. "We would still have an option into the future," he said.