Politics is the story of “who gets what, when and how,” as Yale political scientist Harold D. Lasswell once defined it. In that context, the creation of an ad hoc business advocacy group, the Coalition for Affordable Health Care Choices, to influence the design and operation of the R.I. Health Benefits Exchange is very much a “political” effort.
The spokesman for the coalition, Jim Borah, an insurance broker and president of trade association R.I. Business Health Care Advisors Council, defined the group’s goals within that framework. “We have a desire [for the health-insurance industry] to keep being able to offer a broad range of products for employers, employees and individuals, driven by those who are in the business,” in order to prevent “too much of that power being in the hands of government.”
The group has hired Cara Cromwell, a political consultant who managed John Loughlin’s failed 2010 Republican congressional campaign, to serve as its coordinator.
Borah could not say how much Cromwell is being paid.
At issue is the design and scope of the new R.I. Health Benefits Exchange, established in September 2011 by executive order by Gov. Lincoln D. Chafee, after a legislative effort to create such an exchange failed when it became mired in a political debate over abortion.
Nationally, such exchanges are a centerpiece of the Affordable Care Act, the federal health care reform law, with each state having the choice of designing their own exchange, or having the federal government run it. Under the law, states that choose to establish their own exchange can receive federal grants to help with implementation.
To date, Rhode Island has received about $100 million in federal grants to help establish the exchange.
In Rhode Island, the major responsibility of shepherding the exchange from design to operation belongs to Lt. Gov. Elizabeth H. Roberts. “The exchange is about providing Rhode Islanders easy access to affordable insurance from private insurers,” she said. “It is being built to be simple, to help Rhode Islanders easily understand their options, and to access tax credits to make their coverage more affordable.”