Tag Archives: Replace

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How states can resist Obamacare, and the benefits of doing so

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From the American Spectator, a look at what states can do to block the implementation of Obamacare.

Excerpt:

Although the voters can put an end to the madness on November 6, the states don’t need to wait until Election Day to take aim at a point of vulnerability that remains in place despite the Court’s latest caprice. They can refuse to implement the law’s insurance exchanges.

[…]The law calls for the states to set up these new bureaucracies, whose ostensible purpose will be to provide “marketplaces” in which people with no employer-based health insurance can shop for coverage at competitive rates. Now that the Court has upheld the individual mandate, these insurance exchanges constitute the key to the success or failure of the law. They are also its Achilles’ heel.

How’s that? Well, as the Cato Institute’s Michael Cannon succinctly puts it, “Without these bureaucracies, Obamacare cannot work.” And, oddly enough, the law doesn’t actually require states to set up these “marketplaces.” Moreover, there is no rational incentive for them to do so. If a state sets up an exchange, it then must pay for it, which won’t be cheap. Cannon writes, “States that opt to create an exchange can expect to pay anywhere from $10 million to $100 million per year to run it.” This is a burden that the states, most of which are already in deep financial trouble, are not likely to embrace with enthusiasm.

The federal government can set up its own exchanges, in theory, but Obamacare stipulates that Washington would then be required to pick up the tab as well. And, as Cannon goes on to point out, “The Obama administration has admitted it doesn’t have the money — and good luck getting any such funding through the GOP-controlled House.” And it gets worse. If the federal government is forced to set up an exchange, it faces yet another huge problem. As Sally Pipes and Hal Scherz write, “The text of the law stipulates that only state-based exchanges — not federally run ones — may distribute credits and subsidies.”

Thus, if a state refuses to set up an exchange, the feds have no real ability to do so either. The states have an opportunity, therefore, to shoot a poison arrow directly into Obamacare’s Achilles’ heel.

[…]”Resisting the implementation of exchanges is good for hiring and investment. The law’s employer mandate assesses penalties — up to $3,000 per employee — only to businesses who don’t satisfy federally-approved health insurance standards and whose employees receive ‘premium assistance’ through the exchanges.”

In other words, a state that declines to set up an exchange will protect the businesses of that state from avoidable and job-killing penalties. This reality has apparently begun to sink in. There has been a noticeable decline in enthusiasm for exchanges among states that had begun work on them shortly after Obamacare passed.

The article notes that a bunch of governors and legislatures in conservative states have already taken steps to resist implementing Obamacare, including Louisiana governor Bobby Jindal, who is an Oxford-educated expert in health care policy.

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Keith Hennessey explains one strategy for undoing Obamacare

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In the Wall Street Journal.

Excerpt:

Now that the Supreme Court has ruled ObamaCare’s individual mandate constitutional, the direction of American health policy is in the hands of voters. So how do we get from here to “repeal and replace”?

Step one is electing Mitt Romney as president, along with Republican House and Senate majorities. Without a Republican sweep, the law will remain in place.

But a President Romney does not need 60 Republican senators to repeal core elements of ObamaCare. Democrats lost their 60th senate vote in early 2010 after Scott Brown took Edward Kennedy’s seat. To bypass a Senate GOP filibuster and enact portions of ObamaCare, they used a special legislative procedure called reconciliation.

Reconciliation allows a bill to pass the Senate in a limited time period, with limited amendments, and with only 51 votes; filibusters are not permitted. In 2010, Democrats split their health-policy changes into two bills, one of which they enacted through this fast-track process. In 2013, a Republican majority could use the same reconciliation process to repeal those changes.

The reconciliation process, however, applies only to legislative changes to taxes, spending and debt, or the change must be a “necessary term or condition” of another provision that affects taxes or spending.

Crucial parts of ObamaCare meet this test. Thus, if a President Romney has cohesive and coordinated majorities in the House and Senate, a reconciliation bill could repeal the Affordable Care Act’s Medicaid expansion, insurance premium and drug subsidies, tax increases (all 21 or them), Medicare and Medicaid spending cuts, its long-term care insurance program known as the Class Act, and its Independent Payment Advisory Board, a 15-member central committee with vast powers to control health-care and health markets.

Chief Justice John Roberts ruled that the financial penalty enforcing the individual mandate is within Congress’s constitutional power to “lay and collect Taxes,” and that the mandate and penalty are inextricably linked. This should suffice to enable repeal, through reconciliation, of both the individual and employer mandates, and their respective penalty taxes.

The state exchanges and insurance rules—”guaranteed issue,” which forces an insurer to sell a policy to someone who is already sick, and “community rating,” which severely limits the insurer’s right to charge that person a higher premium—are procedurally more difficult. Yet both are linked to the individual mandate, which increases taxes. Whether they can be repealed in a reconciliation bill will ultimately be decided by the Senate Parliamentarian.

Once the individual mandate is repealed, these popular insurance changes cannot stand by themselves. Without the mandate, people have every incentive to save on premiums and not buy insurance until they fall ill. This will send premiums through the roof for healthy people and, if the government clamps down on increased premiums, destroy private insurance companies. Those Republicans who say they favor legislated guaranteed-issue and community-rating requirements but oppose the mandate will be forced to acknowledge that all three must go.

So, for those who are concerned about repealing Obamacare, this is the way forward. We have a tough battle to get it it done, but it is possible.

News

When you let Democrats control health care, they close hospitals

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From the Weekly Standard. (H/T ECM)

Excerpt:

Under the headline, “Construction Stops at Physician Hospitals,” Politico reports today that “Physician Hospitals of America says that construction had to stop at 45 hospitals nationwide or they would not be able to bill Medicare for treatments.” Stopping construction at doctor-owned hospitals might not seem like the best way to boost the economy or to promote greater access and choice in health care, but that exactly what Obamacare is doing.

Kenneth Artz of the Heartland Institute explains, “Section 6001 of the health care law effectively bans new physician-owned hospitals (POHs) from starting up, and it keeps existing ones from expanding.” Politico adds, “Friday [New Year’s Eve] marked the last day physician-owned hospitals could get Medicare certification covering their new or expanded hospitals, one of the latest provisions of the reform law to go into effect.”

This little-noticed but particularly egregious aspect of Obamacare is, by all accounts, a concession to the powerful American Hospital Association (AHA), a supporter of Obamacare, which prefers to have its member hospitals operate without competition from hospitals owned by doctors.  Dr. Michael Russell, president of Physician Hospitals of America, which has filed suit to try to stop this selective building-ban from going into effect, says, “There are so many regulations [in Obamacare] and they are so onerous and intrusive that we believe that the section [Section 6001] was deliberately designed so no physician owned hospital could successfully comply.”

Artz writes, “According to Russell, the AHA, along with Sen. [Max] Baucus (D-MT) and Congressman Pete Stark (D-CA), are responsible for the language in Section 6001.”  But the responsibility for all aspects of the overhaul primarily lies with outgoing-House speaker Nancy Pelosi, Senate majority leader Harry Reid, and, particularly, Obamacare’s principal champion, President Barack Obama.

This is just like letting the Democrats control energy policy. They block coal production, oil drilling, oil refining and construction of nuclear power plants. What happens where there is less power being produced and demand is increasing because of India and China? Well, supply decreasing, and demand increasing = SHORTAGE = HIGHER ENERGY PRICES. And that’s exactly what they’ve done with health care.

Meanwhile, new conservative House majority leader John Boehner has introduced a bill to REPEAL OBAMACARE. (H/T ECM)