Why States Should Abandon the (ObamaCare) Exchanges

Running the exchanges would be an administrative nightmare for states, requiring a complicated set of rules, mandates, databases and interfaces to establish eligibility, funnel subsidies, and facilitate purchases. All of this would have to take place under broad and often incoherent statutory requirements and federal regulations that have yet to be written.

The exchanges would create unsustainable pressures on each state’s insurance market, treating similarly situated people differently by providing far greater subsidies for those in the exchanges than those in employer plans — yielding perverse incentives that distort consumer and employer decisions and increase costs.

States would endure all this simply to become functionaries of the federal government. The idea that creating state exchanges would give states control over their insurance markets is a fantasy. The states would be enforcing a federal law and federal regulations, with very little room for independent judgment.

James C. Capretta and Yuval Levin in The Wall Street Journal.

Comments (12)

Trackback URL | Comments RSS Feed

  1. Bill Radiar says:

    This may take some time.

  2. Devon Herrick says:

    At the NCPA we have previously argued that states should at least consider running their own exchanges if they hope to have any control over the products sold in the exchange. The Administration so badly wants the PPACA to be a success that we believe there is some flexibility in what the Administration will allow. That said, I also understand how tempting it is for states to just throw up their hands and let the feds do the job for them. Running a state-based exchange is probably an exercise in futility involving states banging their collective heads against the wall trying to comply with the federal regulations.

  3. Don Levit says:

    Devon:
    Do you kbnow where in the law, it provides states flexibility in designing their health insuramce programs?
    Can you provide the excerpt and location.
    Don Levit

  4. Louise says:

    It seems like many states would be better off, though — I like Devon’s perspective. There’s some room for optimism there even if it’s more likely the states will fail.

    It seems time to realize that this law isn’t going away as soon as many would like and try to figure out strategies to proceed in this framework. Anything else cedes the discussion to those who would argue for much more federally-directed and inflexible policies.

  5. Cindy says:

    That’s so unfair to everyone that’s done exactly what they were supposed to, held down a job to keep their insurance… It’s frustrating and a little sad.

  6. Robert says:

    I agree, Devon…I can’t see the market being fairly on both sides.

  7. Rhezna says:

    “All of this would have to take place under broad and often incoherent statutory requirements and federal regulations that have yet to be written.”

    Incoherent, confusing, incomprehensible, discordant, dumb, irrational…call it whatever you want, it’s all summed up in one word at last…UNCONSTITUTIONAL.

  8. Baker says:

    @Rhezna I’d like to point out the the Supreme Court ruled that this section of the healthcare law is constitutional

  9. Thomas says:

    Administration would be even less coherent on the federal then.

  10. ROSEY says:

    WHO CARES IF A STUPID ASS SUPREME DUMB ASS COURT SAIS IT;S CONSTITUTIONAL IT”S STILL SOCIALISM CRAP CHEAP SUB STANDARD MEDICAL FOR YOUR KIDS AND YER GRAND KIDS WILL PROBABLY GO TO GOVERNMENT DRIVE THROUGH CARE FOR SOME ASPRIN WHILE THEY BLEED TO DEATH AND ARE TOLD WE DONT COVER PROFUSE BLEEDING,,SORRY DONT WANNA BE LIKE ENGLAND HIGHER COST EVERY YEAR AND LESS BENIFITS EVERY YEAR ,,DO ANY OF THEESE DUMB ASS LIBERALS EVER TRAVEL!!!!!!!!!!!!!!!!

  11. ROSEY says:

    govenment doing medical for us pretty scary considering no government crap ever comes in on time or on budget and 25% of all government shit fails totally; you liberals keep trusting the govrnmnt what losers guess they grow up and seek out a new parent to take care of them,,grow the hell up welfare lovers

  12. Jackson says:

    On many levels, I am more offended by the so called generic spammer” than by the less artful spammer. You may ask why Because at least the obvious spammer is more open and honest about their spam! We can spot what they are doing. The generic spammer is a cheat and also a charlatan You can probably spot that I have very strong opinions towards this group of charlatans Jackson http://blog.roodo.com/tallertina/archives/2012-04.html