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Now that a federal health exchange is expected in Wyoming, state lawmakers have begun pondering their next move.

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Given that Wyoming would pay for the exchange the same way, Rep. Keith Gingery, R Jackson, wondered about the downside of simply leaving the program to the federal government.

Legislators have other options. They could agree to run the exchange in partnership with Washington, or create an independent, state Nike Mens Classic Cortez Vintage Anthracite Gold

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"I think it is a matter of philosophy," she told the committee. "The question is: To what degree do we want to preserve the regulation of our own markets within our own borders?"

If your comment was not approved, perhaps.

The Joint Labor, Health and Social Services Committee debated legislation Tuesday that would create a group tasked with answering the question of what to do next. The group, which would be comprised of Nike Cortez Grey Blue

A steering committee spent more than a year assessing various models for a Wyoming exchange. They didn't reach a final conclusion, but expressed little interest in leaving the exchange in the hands of federal officials. Supreme Court ruled on the constitutionality of the health reform law, which it did in June. Wyoming now doesn't have enough time to create an exchange by federal deadlines.

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They could sit back and let the federal government operate the exchange a virtual marketplace where consumers can purchase insurance without any state involvement. But that could result in more federal control over Wyoming's insurance market.

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"We need to decide if we want to do it Wyoming's way or the federal way," Sen. Dan Dockstader, R Afton, said.

Some have questioned whether the federal government will Nike Cortez Id actually run exchanges for states that fail to comply. But committee

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seven lawmakers, would offer recommendations to Gov. Matt Mead and the Legislature.

The health committee postponed a vote on the legislation until it meets next month in Cheyenne. The lawmakers remained undecided on whether they wanted language in the bill that would prohibit Mead or anyone else in government from committing to a state exchange until the Legislature meets in 2014.

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It comes down to how much control Wyoming wants to cede to the federal government, explained Elizabeth Hoy, a health care policy adviser for Mead.

The federal government is expected to pay for its exchange by passing on administrative costs to consumers who use it. Another option would be taxing insurance companies.

Given that reality, the new group would be tasked with studying the federal exchange's progress and helping the state develop a long term strategy, Harvey said. "We need to know what we can do," she said.

run program. But those possibilities carry their own consequences.

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The Affordable Care Act requires all states to operate health exchanges by January 2014. Federal officials have promised to run exchanges on behalf of states that don't comply.

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Wyoming lawmakers ponder next move

chairwoman Rep. Elaine Harvey, R Lovell, said officials with the Department of Health and Human Services have assured her they will follow through.

Sen. Charlie Scott, R Casper, supported the prohibition. He questioned whether the benefit of an exchange making it easier for consumers to shop for insurance and compare plans justifies the cost. Passionate views, pointed criticism and critical thinking are welcome. Name calling, crude language and personal abuse are not welcome. Moderators will monitor comments with an eye toward maintaining a high level of civility in this forum. Our comment policy explains the rules of the road for registered commenters.

The establishment of a federal exchange doesn't preclude Wyoming from taking over the program in the future. Wyoming could also work out a partnership with other states, or with the federal government, Harvey noted.

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