Questions Remain One Week Away from Exchange Kick Off

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JEFFERSON CITY - Whether you call it "Obamacare" or the Affordable Care Act, it seems like the federal health care law is here to stay.

"Congress passed it - the president signed it - and the supreme court upheld it. It's the law of the land. And it's not within our power to rewrite federal laws, even if we wanted to," said Missouri Gov. Jay Nixon during his State of the State address earlier this year.

But Missouri lawmakers have grappled with that reality - pushing back on almost everything in the law. It started in 2010 soon after congress passed the law. That's when lawmakers passed House Bill 1764 that would reject the federal mandate to buy health insurance. Later that year, Proposition C passed with a nearly three to one margin of victory. Marking republican's first big win in the state against the federal health care law.

"It's a huge statement, you can't deny that and Missouri is the first in the nation so it will be interesting to see how the other states in this nation progress and follow suit," said Rep. Jeanie Riddle, R-Mokane, in 2010.

A year passed and lawmakers pushed back again when they learned Governor Nixon's administration planned to take federal money to set up a state-based health insurance exchange. That drew staunch criticism from Republican lawmakers.

"What are we doing here?" asked then-Sen. Luann Ridgeway, R-Smithville. "They're just going completely over our head, the constitution's out the window, the republic is dissolved and we're gonna have a dictatorship by fiat that they're going to do this regardless of what we're doing. Talk about the height of arrogance."

Then in 2012, Sen. Rob Schaaf, R-St. Joseph, sponsored Senate Bill 464 that would prevent Missouri from setting up a state-based exchange without legislative approval. Once again, lawmakers passed and the voters overwhelmingly approved the measure. Leaving Governor Nixon out of options.

"Based on current state law and the federal deadline the state based option is not on the table for Missouri," said Nixon in a press conference after the 2012 elections.

After the dust settled, Missouri is now one of 27 states that chose not to set up a state-based insurance exchange.

Missouri's northern neighbor, Iowa decided to partner up with the federal government to set up its exchange. While to the east, Kentucky decided to set up its own without the help of the federal government.

Experts say they aren't sure how much that will matter in the long run, there's still a lot of questions about the exchange.

"If you're a federally facilitated exchange state you probably will go to the same website. Again, we don't know. We haven't seen models on this, we don't know rates, we have a week to go and we just don't know," said Larry Case, the Executive Vice President of the Missouri Association of Insurance Agents.

But one thing is for certain, when Oct. 1 comes one of the cornerstones of the federal health care law will be in place in the state of Missouri.