Coming to a neighborhood near you: nonprofit health coops
administered by ACORN designed to use state Medicaid programs to
usher in single payer health care.
A Tea Party conspiracy theory? Hardly. While the catfight over
the cost of reform and the nature of the public plan escalated as
details unfolded, no one paid attention to what the harmless
sounding exchanges actually do.
Few policy analysts or policymakers have carefully examined the
role exchanges will play in expanding government run health care
with the help of community organizers (known as “navigators” in
the health bills). As American Enterprise Institute health
scholar Tom Miller points out: “The national
exchange initially was marketed as a means to provide new choices
to those largely shut out of the traditional employer-sponsored
group health insurance market. But the House bill gives away its
ultimate objective by authorizing the Orwellian ‘Health Choices’
commissioner to open the national exchange to ALL workers, even
in large self-insured employer plans, by 2015…. It empowers that
commissioner and her forthcoming bureaucracy to fill in most of
open-ended opportunities for regulatory commands and controls,
over time.”
Specifically, Miller notes that health exchanges will be used to
limit what Americans can spend on health care each year by
deciding what type of benefits they will receive, the plans they
can choose from, and how much health plans can charge.
Health exchanges are, in one respect, just another name for the
Health Alliances that regulated health plans under the Clinton
health proposal. In Clintoncare, as in current proposals, only
qualified health plans would be eligible to sell insurance inside
an alliance (exchange) and would be required to cover all the
benefits a National Health Board (Health Choices Commission)
established for a certain amount of money per person.
Exchanges would also have the power to implement premium targets,
control the rate of premium increases through regulation, or
impose taxes on high-cost health plans consistent with federal
regulations.
If that sounds like it would lead to less choice, you are right.
Heritage Foundation health scholar Robert Moffitt observes:
“If the President wanted to create a national market for health
insurance, he could simply propose the repeal of outdated
provisions of federal law that erect barriers to the purchase of
health coverage across state lines. The President is obviously
not interested in creating anything like a normal national,
competitive market for health insurance.”
Instead exchanges reduce the number of private health plans by
controlling prices and the introduction of new technology.
Moreover, exchanges also have significant power to introduce an
“all-payer” system if other health care plans are deemed not
affordable. The House health bill allows the Health Choice
commission to terminate state exchanges that do not meet federal
standards of price and benefits. The Baucus bill, by letting the
exchange regulate premium rates and benefits levels, paves the
way for the steady erosion of private coverage as well.
But that’s not all. The Left is already planning to push for
exchange-led expansion of a combination of Medicaid and the State
Children’s Health Insurance Program (SCHIP) to compete directly
with health plans. By aggressively cornering the market on
“navigation” contracts, these groups seek to lobby for such
alternatives at the state level.
None of the current proposals prohibit Medicaid or SCHIP (both
have no requirement to screen for illegal immigrants) from
participating in state exchanges. States could use both to form
their own “public options” or health cooperatives and compete
alongside private plans. (Similarly, a decade ago community
activists pushed to use Medicaid for SCHIP instead of private
health plans.)
Government-run health care could rapidly expand through
exchanges. All congressional proposals would add 28 million more
Americans to Medicaid. Why create a new public plan for the rest
of us when states could use the two existing public options,
Medicaid and SCHIP? Why not have “navigators” use them to create
health cooperatives?
Best of all, the establishment of and enrollment in these
exchange-sponsored public plans would be aided by a familiar
nonprofit organization.
Exchanges have to contract with “navigators” — nonprofit
organizations that know health care and know how to enroll hard
to reach people. Enter
Nets2Ladders, “a powerful, automated benefits enrollment
platform” designed to “increase the efficiency and effectiveness
of enrolling low-income families in federal and state benefits
programs” such as Medicaid and SCHIP. By January 2010, all 50
states will be covered by this platform. And nearly 26 states
have contracts with the group that administers the program
already.
The organization? ACORN of course. No organization is better
suited to be a health exchange “navigator.” Which tells you
everything you need to know about the real intent and impact of
health exchanges.
