No matter what he’s selling, states know there’s no way out of the fiscal trainwreck that is Obamacare.
The strings attached to President Barack Obama’s Monday offer to allow state waivers out of certain Obamacare requirements are designed to earn Obama political credit for appearing flexible while restraining states from actually implementing any programs that might avoid the fiscal train wreck imposed on them by Obamacare
President Barack Obama suggested that he is willing to give states a way out of some of Obamacare’s most onerous requirements in 2014, three years earlier than allowed under an existing provision in the law. But much like the Obama administration’s refusal to move for expedited Supreme Court review of his signature “achievement,” the president’s offer to the National Governor’s Association, “If you have a better way of doing it, help yourself,” is a ploy to gain time for his federal takeover of the health insurance industry to become so ingrained within the federal government’s power that it becomes all but impossible to eliminate.
Obama’s “offer” is a poisoned bait which Republicans must not even nibble on.
While a well-intentioned governor focused on keeping Obamacare’s expansion of Medicaid from bankrupting his state might be inclined to request a waiver, there are two key reasons he (or she) should avoid that temptation:
First, it will increase rather than decrease the chances that we remain forever saddled with massive federal involvement in health insurance. Second, the availability of these statewide waivers is a mirage.
A waiver allowing a state to implement its own plan would require at least the following of the plan:
• Cover as many people with health insurance as Obamacare.
• Insurance coverage at least as “comprehensive” as under Obamacare.
• Insurance just as “affordable” as under Obamacare.
• No increase in the federal budget deficit.
Unfortunately, while any one of these provisions might be theoretically achievable by a state, doing all of them will prove impossible, at least without bankrupting that state. More importantly, since the impacts will have to be estimated in advance rather than measured retrospectively, analysis of and decisions about state plans will be every bit as politicized and fudged as the numbers bandied about regarding Obamacare itself.
For example, the Obama administration claims that the Patient Protection and Affordable Care Act (PPACA), the official name of Obamacare, will cover 32 million currently uninsured Americans. While some of that would certainly happen because of the plan’s massive increase in Medicaid, the estimate also includes people whom the administration believes – or at least claims to believe – will buy insurance because Big Nanny tells them to. However, the penalty for not buying insurance is so much lower than the cost of insurance that the plan is likely to cover far fewer people than claimed.
If a future administration’s Secretary of Health and Human Services is as blind to reality and as subservient to the political wishes of her boss as Kathleen Sebelius is — and what political appointee won’t be? — the federal government will simply estimate the state’s plan to cover fewer people than Obamacare does and deny the waiver — especially if the requesting state is “red” rather than “blue.”
The impact on the federal deficit will be even easier to game. After all, any administration that could with a straight face claim that Obamacare will reduce the federal deficit could claim that the moon is made of green cheese — or that a state’s plan is worse for the federal budget than PPACA is. And any Democrat administration will do just that if a state’s plan poses a perceived threat to the federal government’s involvement in health insurance. Obamacare is, after all, more about power and vote-buying than about a quality health care system for our nation.
PPACA’s wishful thinking about “affordable” and “comprehensive” insurance is based on massive government subsidies and the cynically rosy assumptions typical of the Obama administration. (Who can forget that if we passed the “stimulus,” unemployment would stay below 8%?) No state can afford similar subsidies which will be needed to provide insurance covering every ailment under the sun, every pre-existing condition, and almost every person in the state. In other words, no state will be able to meet the waiver provisions while also keeping health insurance as “affordable” as PPACA because states can’t redistribute income on the scale that the federal government does to mask the true price increases.
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