A lot of conservatives and Republicans are reluctant to talk about ways to reform the national health care law while legal challenges and repeal efforts are still pending, but in the Wall Street Journal today, Mitch Daniels considers the question, “If the new law is not repealed by 2013, what could be done to reshape it in the direction of freedom and genuine cost control?”
He goes on to say:
I have written to Kathleen Sebelius, secretary of Health and Services (HHS), saying that if her department wants Indiana to run its program for it, we will do so under the following conditions:
• 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.
While this would be slightly less bad than ObamaCare, it’s important to realize that it still wouldn’t do much to alleviate the significant problems with the law that Daniels’ outlines at the start of the piece. Nearly all of the spending in the national health care law comes from expanding Medicaid and offering subsidies to individuals to purchase insurance on these government-run exchanges, and this wouldn’t change that. And while getting rid of benefit mandates would provide individuals with more choice in the exchanges, it would still be hard to contain the growth of premiums as long as there’s a requirement that insurers cover those with pre-existing conditions. Furthermore, given the raft of new regulations introduced by the law, you aren’t going to get anything close to aproximating a consumer-driven system. What this article really does is reinforce why repealing the law is so crucial.