LINCOLN — Two new Nebraska coalitions are pushing conflicting ideas about how best to carry out federal health care reform in the state.

But both say Nebraska should run its own health insurance exchange rather than leave the job to the federal government.

The exchanges are a central feature of the federal overhaul. They are to be "one-stop shops" where people can compare and buy health insurance and enroll in public benefits.

Subsidies to help people afford insurance will be provided through the exchanges.

On one side of the debate are eight consumer organizations, among which are AARP, the Center for Rural Affairs and the Appleseed Center for Law in the Public Interest.

The group released a paper Thursday calling for an independent, consumer-driven board to govern the exchange.

To prevent conflicts of interest, the group said the board should not include health insurers, insurance agents, health care providers or other vendors that may seek business from the exchange.

"We think consumers need to be the focal point of the exchange," said Mark Intermill, advocacy director for AARP Nebraska.

The group said health insurers, providers and others could be given a voice through a separate advisory board.

On the other side is the Nebraska Health Care Alliance, a newly formed group of health care providers and insurers.

Among alliance members are Blue Cross Blue Shield of Nebraska, the Nebraska Medical Association and the Nebraska Hospital Association.

They say the state exchange board should include health insurers and others with experience providing insurance.

"Everyone has a conflict of interest," said Dr. David Filipi, an Omaha physician. "It would be wise to have a wide variety of expertise on the board."

Both the alliance and the consumer group are gearing up as Nebraska policymakers start weighing key decisions about creating a state health insurance exchange.

Filipi said the alliance was created primarily to promote a state-run exchange and to push policymakers to take the steps needed to get an exchange going.

Being state-based means the exchange could be better tailored to Nebraska and decisions could be made by state residents.

"We don't trust the federal government to manage health care in Nebraska the way a state exchange would," Filipi said.

Intermill, with the consumer group, agreed that a state exchange would give Nebraskans more ability to steer the policy decisions.

However, he noted that a third option — joining a multistate exchange — could have some benefits. It would allow for a larger insurance pool.

If the state decides to create an exchange or join a multistate one, lawmakers would have to pass enabling legislation next year. The federal law requires exchanges to be up and running by January 2014.

The Nebraska Department of Insurance has a $1 million federal grant to study the state's options.

The department is looking into the feasibility of an exchange and collecting input from the public and various stakeholders about how an exchange should be set up.

State Insurance Commissioner Bruce Ramge said he expects to have a report and recommendations by Sept. 30.

Nebraska lawmakers will get a briefing on the process Monday during a joint meeting of the Banking, Commerce and Insurance and the Health and Human Services Committees.

Filipi said the state should move forward with implementing the federal law despite pending court challenges. Nebraska would not have time to set up its own exchange if it waits for the U.S. Supreme Court to rule and the law is found constitutional.

Nebraska is among 26 states and a business group that joined in one case, now awaiting the decision of a federal appeals court in Atlanta. A Florida judge ruled in the case that the whole law was unconstitutional.

Another judge overturned the part of the law that requires all Americans to get health insurance. That case also is on appeal.

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