Minimum Demands for States to Run the New Exchanges
This is Indiana Governor Mitch Daniels writing in The New York Times:
- We are given the flexibility to decide which insurers are permitted to offer their products.
- All the law’s expensive benefit mandates are waived, so that our citizens aren’t forced to buy benefits they don’t need and have a range of choice that includes more affordable plans.
- The law’s provisions discriminating against consumer-driven plans, such as health savings accounts, are waived.
- We are given the freedom to move Medicaid beneficiaries into the exchange, or to utilize new approaches to the traditional program, instead of herding hundreds of thousands more people into today’s broken Medicaid system.
- Our state is reimbursed the true, full cost of the administrative burden to be imposed upon us, based on the estimate of an auditor independent of HHS.
- A trustworthy projection is commissioned, by a research organization independent of the department, of how many people are likely to wind up in the exchange, given the large incentives for employers to save money by off-loading their workers.
Interesting set of regquirements, but I’d rather see the whole thing repealed.
Daniels says he’s hoping for a legislative or judicial miracle. I am not that optimistic. I think the whole thing will have to turn into an economic train wreck before the rest of the country wakes up.
ARe these nonnegotiable demands?
Gov. Daniels is one of the few governors pleading the 10th Amendment. Most governers have hat in hand, begging for scraps from the federal trough.
My fear is that the flexibility for states to run their own exchange can also create bad incentives for state that want to be activist.
Subsidized insurance in the exchange is likely to be too expensive anyway, so it’s Medicaid for all.
Surely it can’t be Governor Daniels’s responsibility to show the president how to find the way to real health-care reform. His approach threatens the success of the still-monumental task of repealing Obamacare.
Don’t get me wrong: Governor Daniels issues a full-throated call for consumers, rather than bureaucrats, to decide which health insurance they choose. Daniels knows whereof he speaks: By offering policies linked with Health Savings Accounts to government workers, Indiana trimmed public-sector health costs by 11 percent, according to a previous op-ed in the same newspaper by Governor Daniels.
Daniels knows that Obamacare expects states to do its dirty work. If states boycott Obamacare, forcing Secretary Sebelius’s Obamacrats to set up Health Benefits Exchanges on their own, the results will be as pathetic as the high-risk pools that rolled out in 2010. But this simply invites the question: Why is Governor Daniels (or Governor Perry of Texas, another signer of the letter) extending the hand of peace to Secretary Sebelius — especially now, when Obamacare has been mortally wounded in the courts and the U.S. House of Representatives?
To be sure, Daniels has to manage things as they are, not as he might wish they’ll be after the Supreme Court or the November 2012 election concludes the defeat of Obamacare. Nevertheless, collaboration with Secretary Sebelius attracts risks that should be readily apparent to skilled politicians like Daniels and Perry.
Suppose, for example, that Secretary Sebelius does give way enough to make a deal with these conservative governors. Surely President Obama will exploit such a compromise for all it’s worth on the campaign trail, demonstrating the “flexibility” of his signature “reform.” I’m surprised that these Republican governors are willing to accept responsibility for such a consequence.
Furthermore, Daniels admits that he’s asking Secretary Sebelius “to abandon most of the command-and-control aspect of the law as written” (emphasis mine). Well, if the reforms that he and the other governors are demanding would require changing the legislation, there’s a heck of an easier way to do it than entering tedious, stressful, and likely inconclusive negotiations with Secretary Sebelius.
It’s called “Repeal and Replace.”
What are the expensive mandates?
Steve