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.
Therefore, any state plan designed to meet the coverage
requirements will inevitably rely on federal subsidies. Health care
bureaucrats in HHS and in the Center for Medicare and Medicaid
Services (CMS) will then create their newest Orwellian calculation
proving that the state’s plan will increase the federal budget
deficit and the waiver will be denied.
Even in the imaginary situation where a workable state
plan could be devised, an objective review of which would show it
to meet all the waiver requirements, a Democrat analysis will use
wildly different assumptions to reach a different conclusion.
Remember, this is the party that says the “stimulus” has “created
or saved” three million jobs and wonders what the definition of
“is” is.
The provisions of the waiver plan — a plan originally
introduced by Senators Ron Wyden (D-OR) and Scott Brown (R-MA) —
are the health care equivalent of whack-a-mole. Every time a state
tries to meet one of the requirements, they’ll find the federal
government — at least if a Democrat is in the White House —
popping up their pointy little bureaucrat heads and saying “Sorry,
you don’t meet this other requirement.”
As Senator Orrin Hatch (R-UT) said in an
interview on PBS, “Don’t think that those
waivers mean anything; they really don’t… The reason they’re not
going to work is that they pound all this stuff on top of the
states run by nothing else but the almighty federal government. And
I know what’s going to happen: If President Obama is re-elected,
within a couple of years he’s going to throw his hands in the air
and say ‘this isn’t working, we must go to a single payer system,’
in other words… socialized medicine.” (For those who still have any
doubt as to the leanings of even the best-mannered “mainstream”
talking heads, one can hear a muffled chuckle from PBS’s Judy
Woodruff as Hatch is speaking.)
The left’s future rhetorical tactics are already on
display with Mrs. Sebelius saying that Senator Hatch’s skepticism
about the waiver plan is because Hatch “clearly has some objection
to covering all Americans…”
So when Barack Obama tells the nation’s governors “Go
ahead, take that route,” it’s the political equivalent of “Please,
Br’er Republican, don’t throw me into that briar patch!” After all,
would Obama really support letting whole states opt out of his
dream of socialized health insurance? Republicans will be making a
fatal political and fiscal error by even dipping their toes into
the poisoned well of Obama’s faux-offer of state waivers from
Obamacare.
