If there is one issue that unites Republicans and Conservatives of every type it is opposition to federal involvement in health care. The past two years plus have seen daily, indeed hourly attacks on any activity that the Feds have considered undertaking with respect to improving the health care system in the United States. According to Republicans there should be no, absolutely no involvement of the federal government, and any involvement by government should be done at the state level.
So it is with great irony that everyone learns that Republican controlled states are, for the most part, going to opt out of state control and management of the health care exchanges that have to be set up under the health care reform act.
Just 18 states and the District say they plan to operate their own exchanges, which are slated to begin enrollment in October. In an additional 32 states, the exchanges will be run either entirely by the federal government or a federal-state partnership.
So what happens with those states, do they get to be free of the dreaded health care law? Well, no.
The vast majority of Republican-led states, faced with a Friday deadline to submit plans for running the insurance exchanges at the heart of the law, have opted instead to relinquish much or all of their control to the federal government.
Even the friends of Republicans see the idiocy here. First of all
The states that run their own exchanges, for example, will decide whether to allow all health plans that meet the law’s minimum standards to be sold on the exchange or to limit the selection to a few that regulators think offer the best value.
In the federally run exchanges, federal officials will make that call.
And so allies of the Republicans, that is, those allies who still have shred of rationality left react this way.
“If you believe in states’ rights and you believe in state control, why would you cede that control?” asked Robert Laszewski, a prominent insurance industry consultant.
A longtime critic of the health-care law, Laszewski argues that Republican state leaders have allowed their ideological and political differences with President Obama to override pragmatic considerations, to the detriment of their residents.
“There’s a lot of cut-off-your-nose-to-spite-your-face going on,” he said.
But maybe there is a rational process going on here. After all, how can Republicans complain of a federal takeover of health care unless the abdicate their own responsibility and allow that to happen.