The Affordable Care Act requires states to have exchanges. A state has several options: It can build the exchange itself, or it can collaborate with the federal government to build it, or it can let the federal government run it. The state has to tell the feds what path it has decided to take by mid-November. If the state does not want to run its own exchange, or collaborate with the feds to run it, the feds will begin setting up the exchange themselves in January.
If Jindal is serious about not implementing an exchange, the latter course is what will happen under the law, says Kathleen Stoll, the deputy executive director at the pro-Obamacare Families USA.
“If the state hasn’t moved forward, at that point, the feds have to come in to run the exchange to protect the citizens of Lousiana,” Stoll says. “The irony is that Jindal has made a choice to waste time and available federal dollars he could have used to build a state exchange uniquely tailored to his vision and the needs of the people of Louisiana.”