MADISON (WKOW) -- Governor Scott Walker (R-Wisconsin) has just two more days to decide whether he wants any part of implementing the Affordable Care Act here in Wisconsin.
States must notify the federal government by Friday if they plan to run their own health insurance exchanges, which are mandated under the law.
Governor Walker has made it known that he doesn't like "Obamacare", but he knows many in Wisconsin's business and insurance communities would feel better if the state ran those exchanges.
More than 90 percent of Wisconsin residents already have health insurance.
UW health policy expert Donna Friedsam says state business and insurance groups realize the market here is unique.
"From a business perspective, they want to see that continue and continue to have a thriving private and employer sponsored health insurance market," said Friedsam.
That's why some traditionally conservative groups like Wisconsin Manufacturers and Commerce want the big decisions about the state exchanges made in Madison.
And in that scenario, the state could exercise control over a number of issues.
"Rating plans for their quality, only allowing certain kinds of plans into their exchange, trying to steer consumers to certain kinds of quality and cost arrangements with their plans and getting very active in those arrangements," said Friedsam.
The state could also keep it more stripped down.
"A farmer's market model where everybody's out there and people can choose and there's not a lot of direction provided," said Friedsam.
That choice would be taken away from Wisconsin if the federal government runs the program completely.
But, some hard-core conservatives still believe the Governor should let that happen.
"You will have people who will assert that if the state takes on an exchange that we're gonna be left holding the bag for operating this exchange down the line," said Friedsam.
There is a third option: a state and federal partnership, in which Wisconsin would manage the plans and could provide consumer support, while letting the federal government handle all of the technical aspects.
"I do think what it does is provide states some breathing room to work on some of these more substantive issues, without perhaps getting so bogged down in the heavy lifting of the IT," said Friedsam.
If the Governor submits a letter of intent to have the state run the exchanges by Friday, Wisconsin wouldn't have to deliver an actual blueprint for that plan until December 14th.
If Governor Walker decides against state-run exchanges, he would still have until February to decide on the state and federal partnership option.
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