Countering HHS Doublespeak on Health Insurance Exchanges

Kaye Beach

August 12, 2011

If you remember nothing else from the following Health Freedom Watch article article-remember this about so-called “state based” health insurance exchanges;

“Who administers the exchanges, however, is unimportant. What counts is who writes the rules that govern them. Those rules will be written entirely in Washington”

Remember this date too-Sept. 14 2011 in OKC-the Joint Committee on Federal Health Care Law, a special legislative committee that will study how the new federal health care law affects Oklahoma, has its first meeting on Oklahoma City.



The U.S. Department of Health and Human Services (HHS) has released its first set of proposed regulations on the American Health Benefits Exchanges required under President Obama’s health “reform” law. The deadline for public comments is September 28 , 2011 . In its announcement on the proposed rules, HHS officials claimed that exchanges:

  • are state-based competitive marketplaces;
  • will offer individuals and small businesses the same affordable insurance choices as members of Congress; and
  • will provide Americans clout.
However, the claim that exchanges are “state-based” is countered by 811 uses of the word “require” in the first set of proposed regulations, according to Chris Jacobs of the Republican Policy Committee, as reported by Politico Pulse. Shortly after the release, HHS was forced to retract a key part of its claim:
Trumpeting the advent of the exchanges, the administration said Monday that they would “give Americans the same insurance choices as members of Congress.” However, in response to questions after a news conference on Monday, health officials acknowledged that this claim was not necessarily correct.
Under the rules, an employer may allow employees to choose any health plan at a given level of coverage. But an exchange may also allow an employer to limit its workers to one or two health plans – far fewer than the number available to members of Congress and other federal workers.
The claim that exchanges are competitive “marketplaces” with choice and clout is also challenged by the fact that the law outlaws catastrophic major medical insurance and limits insurance options in the exchanges to managed-care plans.
Calling an exchange a marketplace is a carefully crafted strategy. Herndon Alliance published a two-page paper that strongly encourages using the word “marketplace” when discussing exchanges. Its list of “good words” – which includes “control,” “choice,” “consumer” – features the word “marketplace” with the following statement:
[T]his term was preferred over exchange. Public associates marketplace with purchasing and exchange did not conjure up the notion of purchasing. Also use marketplace not market (the public identifies “market” with groceries)
HHS asserts that the draft proposal gives states significant flexibility to build an exchange that works for them. But Michael Cannon of the Cato Institute has already refuted that assertion in National Review:
[S]upporters have sought to frighten Republican governors into implementing the law by holding out the nightmare scenario of the federal government’s administering the exchanges. Who administers the exchanges, however, is unimportant. What counts is who writes the rules that govern them. Those rules will be written entirely in Washington. (Emphasis mine)
Four more exchange regulation proposals will be published. Despite the rhetoric, it’s clear that Washington intends to govern the states through the exchanges. As evidence, using a word search feature, here is a list of key words and the number of times they appear in the 62-page proposed “Establishment of Exchanges” rule, the longest of the first set of proposed rules:
Public comments are due by 5 p.m. September 28, 2011. Refer to file code CMS-9989-P for the Exchange Framework rule or CMS-9975-P for the Reinsurance, Risk Corridors and Risk Adjustment rule. Electronic comments can be submitted at .

Health Freedom Watch is a monthly email newsletter published by the Citizens’ Council for Health Freedom (formerly Citizens’ Council on Health Care), a national nonprofit, educational organization whose mission is to support patient and doctor freedom, medical innovation and the right to a confidential patient-doctor relationship. Health Freedom Watch provides reports on national and state policies that impact citizens’ freedom to choose their health-care treatments and practitioners, and to maintain their health privacy – including genetic privacy. Citizens’ Council for Health Freedom (CCHF) is not affiliated with any other organization. © Citizens’ Council for Health Freedom.

“Affordable Insurance Exchanges: Choice, Competition and Clout for States,” U.S. Department of Health and Human Services,, accessed August 3, 2011.
“Obamacare Exchange Regulations: More New Federal Requirements” email from Chris Jacobs, Republican Policy Committee, July 11, 2011.
“The Exchange (The Competitive Health Marketplace),” Herndon Alliance, accessed August 3, 2011.
“Obamacare Can’t Be Fixed, and Now is the Time to Dismantle It,” Michael Cannon, National Review, March 21, 2011.

3 responses to “Countering HHS Doublespeak on Health Insurance Exchanges

  1. Thank you for reporting this!
    Twila Brase, president, Citizens’ Council for Health Freedom and editor of the Health Freedom Watch.

  2. Twila, Thank YOU for all of you tireless and valuable work. I don’t know what I’d do with out you

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