State Del. Patrick Hope, D-Arlington, has filed a bill in the General Assembly that, if passed, would allow the state to work in partnership with the federal government to create a health benefit exchange.
Establishing an exchange — essentially, an online marketplace where people can access information and purchase insurance — has been controversial in Virginia and other states where the leadership has been opposed to implementing the Affordable Care Act.
Small businesses also can choose to use the exchange. Proponents like Hope say an estimated 500,000 people in Virginia will either gain access to healthcare or a better plan than they currently have.
Under the law, families making up to 400 percent of the federal poverty level — about $92,000 last year for a family of four — would receive tax credits to help them afford coverage.
Republicans generally have seen blocking the creation of an exchange as one way to shake their fists at Obamacare, as the 2010 health care reform law has come to be known, despite a ruling by the Supreme Court on the law's constitutionality and the outcome of last year's presidential election — which at times was cast as a referendum on the act.
"It's pure politics," Hope said. "There's starting to be an acceptance now that the Affordable Care Act is the law of the land. It's not going anywhere. And there's starting to be some acceptance."
According to the law, states must have an exchange in place by 2014 or else the federal government will run one for them. Some deadlines already have passed.
Gov. Bob McDonnell, a Republican entering the last year of his term, said last month Virginia would not establish an exchange. He has a little more than a month to decide if he will support a state-federal partnership or simply let the federal government have total control of Virginia's exchange.
"The governor has not said no to a partnership," said Hope, adding that he believed a similar, Republican-backed bill would be introduced in the state Senate.
"If not this year, next year we'll do a partnership," he said. "So the question is, do we let the feds do it the first year and then gradually take it over? But at some point this bill is going to pass."
Hope cast the matter as a state's rights issue and said despite the number of federal employees in Northern Virginia, the federal government did not have the relationships or knowledge to be an effective provider of health insurance options to central and southwestern Virginia.
The Arlington County legislative delegation spent three hours last week hearing testimony about the community's priorities — and .