Insurance Commissioner Mike Chaney says he does not intend to create a state exchange to offer health insurance to Mississippians unless Gov. Tate Reeves signs off on it.
“We probably could operate the exchange, but I don’t think it is wise to do it without having the governor on board or at least having some of his approval to operate the exchange,” Chaney said during a recent Mississippi Today “The Other Side” podcast. “ … It is the governor’s call whether we will have a state-based exchange. We have done all the other hoops we have to jump through.”
States that operate their own exchanges can typically attract more companies to write health insurance policies, offer people policies at lower costs and it would likely save the state millions of dollars in payments to the federal government.
Chaney said he has not talked to Reeves yet about whether he would submit a letter to the federal authorities saying the state wanted to operate its own exchange instead of being part of the federal Affordable Care Act Marketplace Exchange.
Reeves’s office did not respond to questions from Mississippi Today about whether he would submit the letter.
PODCAST: Insurance Commissioner Chaney says creating state health insurance exchange is a win-win
The Legislature passed a bill during the 2024 session giving Chaney’s office the authority to set up the state exchange. The bill was authored by House Ways and Means Chair Trey Lamar, R-Senatobia. The governor let the bill become law without his signature and without any comment.
But in the past Reeves has been extremely critical of the Affordable Care Act. The exchange was established as part of the ACA. Through the exchange, people can purchase health insurance and people who earn less than 400% of the federal poverty level can receive federal subsidies to help with the cost of the policies.
The federal subsidies are available through both the federal exchange and a federally approved state exchange that adheres to the federal regulations.
Chaney said it’s likely he could entice more companies to offer health insurance on a state exchange and offer policies at less cost than on the federal exchange.
In addition, the companies offering health insurance in Mississippi through the federal exchange currently pay the federal government a fee to operate the federal exchange. If Mississippi was operating its own exchange, it’s estimated Mississippi could save as much as $37 million a year that currently goes to the federal government to pay the cost of operating the federal exchange here.
Lamar said he had not spoken to Reeves about the issue, but assumed the governor would support the state exchange since he did not veto the legislation. He said the goal of the legislation is to recruit more companies to offer policies on the state exchange and hopefully provide more savings to the people purchasing the policies and to the state.
Plus, he said he believed it is better for the state instead of the federal government to be operating the exchange.
When the ACA was passed in 2010, then-Gov. Haley Barbour and Chaney both supported having a state exchange. But then-Lt. Gov. Phil Bryant, who later became governor and like Reeves was a vocal ACA opponent, opposed Mississippi operating a state exchange and blocked that effort.
While Chaney said he is ready to oversee a state exchange as insurance commissioner, he said Mississippi’s participation in the federal exchange has been a success. Currently about 250,000 Mississippian have health insurance through the exchange. Five companies offer health insurance policies in Mississippi on the federal exchange.
Chaney said the Republican Governors Association is now advocating states create their own exchanges. Georgia, with the backing of Gov. Brian Kemp, recently created its own exchange.
Currently 21 states plus the District of Columbia have state-based exchanges, though three still operate from the federal platform.
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