Obama or Romney: How 2012 Elections Will Impact Exchanges

Last week, communications firm ReviveHealth and Catalyst Healthcare Research released results from another survey of healthcare executives. Among the findings:

• A third of respondents say HIX will move forward regardless of who wins, while 46% say that if Romney wins they still expect exchanges to proceed, but only if administered by the states, not the federal government. Nine percent of respondents say a Romney win will mean a halt to HIX. Some respondents speculated about a year's delay of the exchanges or a rollout of private exchanges with states contracting with them for certain target populations.

• Hospital executives also expect all the national health insurance carriers to participate in state HIX, as well as strong participation from managed Medicaid plans.

Cowart notes if Romney is elected, the "artwork" will be in separating out HIX from the Patient Protection and Affordable Care Act without necessarily eliminating them. "I believe that exchanges will continue," he says. But, Cowart notes, the Senate elections can influence that outcome as well.

"If Romney is elected, but the Democrats still control the Senate, in that case the repeal and replacement of the Affordable Care Act becomes much more problematic," he says. "Republicans have to run the table to have a clean repeal and replace, so it's not just the presidential race that matters. And the Senate races are close, too."