JEFFERSON CITY, Mo. – The Affordable Care Act (ACA) mandates the creation of health care insurance exchanges, marketplaces that let individuals and small businesses comparison-shop for health coverage online. Defining the details of an exchange, however, is left up to individual states.

Missouri state senators heard testimony this month about whether or not the Show Me State should even create its own exchange. However, Andrea Routh, executive director of the Missouri Health Advocacy Alliance, says the discussion has stalled because some senators don’t want to implement an exchange system, arguing the ACA is unconstitutional.

“There are some senators who are determined to find ways to have Missouri not implement a state-based exchange. And it’s true, they don’t want the federal government interfering either, but they are betting on it that the Supreme Court is going to overturn the entire federal law.”

Routh says creating their own exchanges allows states to tailor the needs for themselves. States have until 2014 to create their own health insurance exchange system; otherwise a federally operated exchange will have to be implemented.

Kansas City small business owner Dawn Lindsey testified before the senate committee that she’s looking forward to the health insurance exchange as an affordable option. She dropped her insurance plan after her monthly premium went up to about $1,000.

“There’s a vast number of middle class people who don’t fit into the answers that the free market has supplied. And we do fall through the cracks and we are uninsurable. They should care about that.”

The state Senate Interim Committee on Health Insurance Exchanges will make its recommendation to the legislature by year’s end.  (Information from the Missouri News Service)