Wednesday, November 21, 2012

Wall Street Journal Commentators James Capretta and Yuval Levin Urge Republican Governors to Abandon Health Care Reform

Just Say ‘No’ to the Law of the Land

Elections are supposed to have consequences but for Conservatives the result is not that they lost, but that even though they lost they still get to implement their policies.  Here is what some Conservatives are saying.

Champions of ObamaCare want Americans to believe that the president's re-election ended the battle over the law. It did no such thing. 

It should be clear that the electorate endorsed what is known as “Obamacare” and that they want it implemented, even if they are not entirely sure what it means or what it does.

But two Conservatives writing on the opinion page of the Wall Street Journal urge Republican governors to simply refuse to implement the policy.  They say Republican Governors should not implement the insurance exchanges that are the key to expanding coverage for uninsured.

A group of them has already indicated that they will not build the exchanges, and several more seemed ready to opt out as the administration's deadline for state decisions approached on Nov. 16. Predictably, Health and Human Services Secretary Kathleen Sebelius tried to head them off by extending the deadline to Dec. 14. She will try to use the extra month to twist governors' arms. They should resist.

By declining to build exchanges, the states would pass the burden and costs of the exchanges to the administration that sought this law. And it is far from clear that the administration could operate the exchanges on its own.

The law anticipated this, and provides for the federal government to do what states refuse to do.  But the real wrath of these Conservatives is on the expansion of Medicaid.  Medicaid covers only the desperately poor and almost anyone who works, no matter how low the wage rate is not eligible.  The new law would expand Medicaid but these Conservatives want none of that.

In refusing the Medicaid expansion, governors should notify Washington that doing so means freeing themselves of ObamaCare's "Maintenance of Effort" requirements. These would prohibit states participating in the Medicaid expansion from reforming their Medicaid systems to reduce costs.

Oh, so they want to reform Medicaid.  Great, how would they do that?

they should demand that Washington transform the federal portion of Medicaid for non-disabled and non-elderly beneficiaries into a uniform block grant, with state discretion over eligibility and benefits. The goal should be to turn Medicaid into a premium-assistance program rather than government-run insurance. Medicaid could then be used to help people enroll in mainstream insurance plans. This is the way to help the low-income uninsured get the same kind of coverage as other Americans.

Ah, the old ’premium support’ program, giving poor people a small fraction of the cost of a monthly health insurance premium so the poor people can buy their own insurance even though they don’t have the money to do so.  Of course even if they wanted to have their own insurance the insurance companies will not give them the group rates with no pre-existing condition element that they need to buy insurance.

Finally, as frequently noted in commenting on Conservative’s discussion of health care, it should be noted where these authors are employed.

Mr. Capretta is a fellow at the Ethics and Public Policy Center and a visiting fellow at the American Enterprise Institute. Mr. Levin is a fellow at the EPPC and editor of National Affairs.

because it  is almost 100% certain that these people have wonderful employer sponsored health care plans that provide for every health care problem they have at very little cost to them.  But then for Conservatives as long as they have coverage for themselves they really don’t care about anyone else, do they.

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