Gov. Scott Walker and state Republicans are poised to face a looming deadline to implement President Barack Obama’s Affordable Care Act. If they fail to meet the deadline, the federal government will step in.[/media-credit]

In light of President Barack Obama’s re-election Tuesday night, Gov. Scott Walker now faces a looming decision on how the state will implement the president’s health care reform law.

After the Supreme Court upheld most of the Affordable Care Act in June, Walker announced he would wait until the November elections to decide whether Wisconsin would implement the law in hopes that Republicans would gain control and consequently delay the healthcare measure.

With the president re-elected and the Democrats still in control of the Senate, the changes Walker hoped for did not take place, and the federal law will remain.

The law mandates that by 2014 everybody have health insurance. It will also set up health care exchanges, an online marketplace where uninsured individuals and small businesses can purchase insurance. There are three options for these exchanges in terms of who sets them up: the state, the federal government or a partnership between the two. If states do not set up their exchanges, the federal government will do it for them.

In order to have state-based health exchanges, Wisconsin must send a blueprint of its plans to the federal government by the Nov. 16 deadline. Critics say there is currently not enough time to have a complete blueprint, while Republicans say the deadline is not firm and the state has a chance past Nov. 16 to set up their own exchanges.

On Wednesday, Walker said his administration does not yet know which of the three options the state will follow. He added that as the Nov. 16 deadline does not require complete plans from states, there is still time for Wisconsin to decide which route it will take.

“Even after notifying them, we have until next fall to make modifications as we see fit,” Walker told reporters in Milwaukee. “We haven’t made a decision yet. … The question, from our standpoint, is what option is best for the taxpayers of Wisconsin.”

In an email to The Badger Herald, Walker spokesperson Cullen Werwie said the governor will meet with “key members of his administration” in the coming days to see what their suggestions are.

In 2011, Walker set up an office that would look into ways the law could work in the state, seeking input from business leaders and others affected by the law. This January, he eliminated that office and also declined a $38 million early innovator grant from the federal government for setting up state-based exchanges.

ABC For Health Executive Director Bob Peterson said he was not sure the federal government would allow a blueprint that is not as complete as other states’ plans. As Peterson described it, “it takes two to tango” – if Wisconsin does come up with a plan by the deadline, the federal government would need to be flexible to ensure Wisconsin’s plans continue.
Peterson called the exchanges a “new direction in health care” and said they were going to happen either way, so the state should move forward with them.

“It’s a big opportunity for individuals and small businesses to purchase insurance using the concept of pooling,” Peterson said. “There are a lot of ways you can set it up and getting input from a lot of folks is the best way to get an exchange that is reflecting the views of the people of Wisconsin.”