“Insufficient scale to justify investment.  Do not pursue.”

Such was the conclusion of a 2009 report funded by the Robert Wood Johnson’s State Coverage Initiative to investigate then-Lieutenant Governor Elizabeth Robert’s plan for HealthHub RI.  This year, the first budget proposed by Rhode Island’s new governor, Democrat Gina Raimondo, provides proof that the study was right.

In 2009, the idea was to follow Massachusetts, Connecticut, and Washington in setting up a government-run health benefits exchange.  The hope (at least as publicly expressed) was that an exchange would help the state expand access to insurance while lowering the cost of health care.  Yet, members of the group conducting the study “were disappointed to learn that the development of a full exchange model, as established in Massachusetts, would not” accomplish their goals.

A few years later, with the help of the Obama Administration and a party-line vote in the U.S. Congress, creating the Affordable Care Act, otherwise known as Obamacare. Then following an executive order from Governor Lincoln Chafee, Rhode Island officials went ahead and set up exactly the sort of exchange that their report had warned them not to pursue, calling it HealthSource RI.

With the Affordable Care Act requiring federal funding to cease soon, Rhode Islanders are now finding out what “insufficient scale” actually means.

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