Sixteen states including huge Texas are fighting an ObamaCare mandate to set up state-level insurance exchanges. In its story on the fight, The Hill buries a couple of leads.
It’s a situation no one anticipated when the Affordable Care Act was written. The law assumed states would create and operate their own exchanges, and set aside billions in grants for that purpose.
As that’s written, it’s not clear who would be assumed to set the billions aside — the states, or the federal government. But the fact is, neither the states nor the federal government have the billions to set aside in the first place. Either way, the law assumed far too much. California is not fighting the mandate, but has no money to pay for a new bureaucracy (not that a lack of money seems to slow down bureaucracy in that state). Texas has a rainy day fund, but has no interest in spending that money on a policy that its people didn’t want.
One place all of this will inevitably lead, is to higher insurance costs for consumers.
Every state must have an exchange by Jan. 1, 2014, meaning HHS doesn’t have a lot of time to do a massive amount of work. The department could quickly run through a $1 billion fund designated for implementing the exchanges.
Experts have predicted that the department will soon have to tap budgets from its other programs to cover exchange costs. Other have said it might charge fees on the insurance purchased in its exchanges once they are launched.
So the federal government may add a surcharge to pay for the ObamaCare bureaucracy. And there goes any pretense that ObamaCare was supposed to reduce health insurance costs. It was never about that, but you can’t make the argument that it was really a Democrat power grab stick among people who actually think O cares about them.
Once the exchanges are set up, either by states or the federal government, they become perpetual government money spending machines. Someone will have to pay for them. Guess who. Not the people toting Obama phones.
I know I’m whistling past the graveyard here. Barack Obama small-balled, bought, cheated and lied his way to victory (with a big assist from the media) and therefore his atrocious law his here to stay despite House Speaker John Boehner’s call to put ObamaCare on the table as part of the fiscal cliff negotiations. That’s fine but won’t happen. The state fights are fine as far as they go, but they seem more like speed bumps than walls against ObamaCare. ObamaCare will give it to state budgets good and hard sooner, or it will give it to state budgets good and hard later. The religious freedom challenges have won very narrow victories but there is nothing on the horizon that can sweep ObamaCare aside entirely. It’s the law, and a particularly bad one that will hurt millions of us.
The states should continue to fight, but we all may need to rethink our communications on the law going forward. One area in which we Republicans have erred in all this is in how we branded the Democrats’ unpopular law. It’s a leftist power grab that threatens to collapse us into bankruptcy while it turns big government into HUGE government, straight up. But by branding it “ObamaCare,” we may have branded the minds of low information voters with an idea — that Obama cares.






– until the governors disobey the courts.
There is one legal challenge that could do a lot of damage, and lead a lot more states to forego state exchanges: the case arguing that, without a state exchange, employers cannot be fined for not offering the required insurance benefits.
If that case wins, you will see a lot more than just 16 states doing without exchanges.
I think you’re right about the label “ObamaCare” but not for the reason you list. By calling if “ObamaCare” it was easy to portray any opposition as anti-Obama rather than opposition to probably the worst law passed in the past 100 years.
But, at the end of the day, I’m not sure that I care anymore. The young embraced Obama in 2008 and doubled-down on stupid in 2012 so they’re welcome to the health care system that they deserve. The answer appears to be “Go Galt” in much the same manner as the home schoolers have. You may have to pay for the system but you don’t have to use it. In my mind, that’s the sort of “health exchange” that the States should investigate… authorize the creation of an entirely private system where Medicare/Medicade and ObamaCare aren’t automatically treated.
The old saying is “you get what you pay for” so if you’re not paying then you don’t get squat. Heinlein was wrong, Reality is a Harsh Mistress.
It appears (as of Nov 19) that 20 states have declined to set up state-based ObamaCare exchanges:
1-Alabama
2-Alaska
3-Georgia
4-Indiana
5-Kansas
6-Louisiana
7-Maine
8-Missouri
9-Montana
10-Nebraska
11-New Hampshire
12-North Dakota
13-Ohio
14-Oklahoma
15-South Carolina
16-South Dakota
17-Texas
18-Virginia
19-Wisconsin
20-Wyoming
Another 8 are undecided:
1-Arizona
2-Florida
3-Idaho
4-Iowa
5-New Jersey
6-Pennsylvania
7-Tennessee
8-Utah
Info was culled from the Center on Budget and Policy Priorities: http://www.cbpp.org/files/CBPP-Analysis-on-the-Status-of-State-Exchange-Implementation.pdf