As far as the vividness of sayings goes, not much can match the stark imagery of a baby flying out the window with the bath water. It’s one to keep in mind as we consider the issue of readying Arizonans to participate in a federally-facilitated health insurance exchange. While it’s true that Governor Brewer threw the state-run exchange bathwater out the window, we cannot afford to let the baby of affordable coverage and access to go out the window with it.

The same thinking that applied to Medicaid expansion applies here: affordable coverage and access make for healthier people, a supported and supportive health care system, and an ultimately more competitive and economically stronger state. The Governor disavowed a state-run exchange primarily because – in her Administration’s assessment – there was too much risk involved in committing to state level implementation, but that does nothing to negate the principle that coverage and access matter. Medicaid expansion will enable coverage for 300,000 Arizonans, but roughly 900,000 still need a path to affordable insurance. The odds of creating a healthier Arizona depend on successful use of the insurance exchange.

As of this moment, a federally-facilitated health insurance exchange will be open for business in October of this year – some 250 days away. Between now and then Arizona must adopt a culture of coverage, put feet on the ground to spread that culture, educate eligible Arizonans on the exchange and how it works, and get those citizens to enroll in the plan of their choice. No small task, along with no small stakes.

We simply can’t throw out the coverage baby with the state-run exchange bath water. We may have opted out of a state-run exchange because it was believed we couldn’t afford it, but we clearly can’t afford to opt-out of making the federally-facilitated exchange a successful one for the state.