Obamacare Is Still Vulnerable. Now is not the time to go wobbly.

National Review ^ | 11/09/2012 | Michael F. Cannon

[SeekAndFind]

President Obama has won reelection, and his administration has asked state officials to decide by Friday, November 16, whether their state will create one of Obamacare’s health-insurance “exchanges.” States also have to decide whether to implement the law’s massive expansion of Medicaid. The correct answer to both questions remains a resounding no.

State-created exchanges mean higher taxes, fewer jobs, and less protection of religious freedom. States are better off defaulting to a federal exchange. The Medicaid expansion is likewise too costly and risky a proposition. Republican Governors Association chairman Bob McDonnell (R.,Va.) agrees, and has announced that Virginia will implement neither provision.

There are many arguments against creating exchanges.

First, states are under no obligation to create one.

Second, operating an Obamacare exchange would be illegal in 14 states. Alabama, Arizona, Georgia, Idaho, Indiana, Kansas, Louisiana, Missouri, Montana, Ohio, Oklahoma, Tennessee, Utah, and Virginia have enacted either statutes or constitutional amendments (or both) forbidding state employees to participate in an essential exchange function: implementing Obamacare’s individual and employer mandates.

Third, each exchange would cost its state an estimated $10 million to $100 million per year, necessitating tax increases.

Fourth, the November 16 deadline is no more real than the “deadlines” for implementing REAL ID, which have been pushed back repeatedly since 2008.

Fifth, states can always create an exchange later if they choose.

Sixth, a state-created exchange is not a state-controlled exchange. All exchanges will be controlled by Washington.

Seventh, Congress authorized no funds for federal “fallback” exchanges. So Washington may not be able to impose Exchanges on states at all.

Eighth, the Obama administration has yet to provide crucial information that states need before they can make an informed decision.

Ninth, creating an exchange sets state officials up to take the blame when Obamacare increases insurance premiums and denies care to the sick. State officials won’t want their names on this disastrous mess.

Tenth, creating an exchange would be assisting in the creation of a “public option” that would drive domestic health-insurance carriers out of business through unfair competition.

Eleventh, Obamacare remains unpopular. The latest Kaiser Family Foundation poll found that only 38 percent of the public supports it.

Twelfth, defaulting to a federal exchange exempts a state’s employers from the employer mandate — a tax of $2,000 per worker per year (the tax applies to companies with more than 59 employees, but for such companies that tax applies after the 30th employee, not the 59th). If all states did so, that would exempt 18 million Americans from the individual mandate’s tax of $2,085 per family of four. Avoiding those taxes improves a state’s prospects for job creation, and protects the conscience rights of employers and individuals whom the Obama administration is forcing to purchase contraceptives coverage.

Finally, rejecting an exchange reduces the federal deficit. Obamacare offers its deficit-financed subsidies to private health insurers only through state-created exchanges. If all states declined, federal deficits would fall by roughly $700 billion over ten years.

For similar reasons, states should decline to implement Obamacare’s Medicaid expansion. The Supreme Court gave states that option. All states should exercise it.

Medicaid is rife with waste and fraud. It increases the cost of private health care and insurance, crowds out private health insurance and long-term-care insurance, and discourages enrollees from climbing the economic ladder. There is scant reliable evidence that Medicaid improves health outcomes, and no evidence that it is a cost-effective way of doing so.

My colleague Jagadeesh Gokhale estimates that expanding Medicaid will cost individual states up to $53 billion over the first ten years. That’s before an emboldened President Obama follows through on his threats to shift more Medicaid costs to states.

Neither the states nor the federal government have the money to expand Medicaid. If all states politely decline, federal deficits will shrink by another $900 billion.

Now is not the time to go wobbly. Obamacare is still harmful and still unpopular. The presidential election was hardly a referendum, as it pitted the first person to enact Obamacare against the second person to enact it. Since the election, many state officials are reaffirming their opposition to both implementing exchanges and expanding Medicaid.

If enough states do so, Congress will have no choice but to reopen Obamacare. With a GOP-controlled House, opponents will be in a much stronger position than they were when this harmful law was enacted.

— Michael F. Cannon is director of health policy studies at the Cato Institute and co-editor of Replacing ObamaCare (Cato, 2012).

[Arkansas Toothpick]

The Arkansas state legislature is now GOP-controlled (first time since Reconstruction), so I am hoping that we can obstruct this monstrosity at the state level.

[Tau Food]

Government at all levels should get out of the health care business. Medical costs will be drastically reduced if we can get rid of all the "cares" like Obamacare, Romneycare, Medicare, etc. No state is required to participate in any of these intrusive and unconstitutional schemes.

[Lexington Green]

It’s time to monkey wrench commiecare. Non-cooperation at every level.

[TBP]

Tell that wimp Boner.

[TBP]

States need to ban enforcement of the mandate in their states, as three voted to do Tuesday.

[what's up]

But, but....Crybaby Boehner said that "it's the law of the land"

It is the law of the land.

And that includes the states opting out...which Boehner will support.

[TBP]

We should pass a bill defining the Federal taxing power. By defining it in a limited way, we can define Obamacare outside of it.

[TBP]

Don’t count on it. Boner is a squish with no fixed principles.

[Hotlanta Mike]

So if muslims REPORTEDLY don’t have to abide by Obamacare regulations, then why should anyone else under the “equal protection act”?

[what's up]

Boehner didn't allow higher taxes in negotiations with Obama last year. He's got some principles.

He'll stand with the states.

[Steely Tom]

And those making their health care decisions should never know know that it’s someone “important” waiting on that hip replacement.

NO JUMPING IN LINE.

One of Alinsky's rules (#4 I believe) is:

“Make the enemy live up to its own book of rules.”

Why isn't Senator so-and-so subject to the rules of ObamaCare? Why isn't Congressman so-and-so subject to the restrictions of ObamaCare?

I see hundreds of regional bumper stickers.

We must ride this angle mercilessly.

If ObamaCare is good enough for us, it's good enough for them.

I can also see something else: a pledge.

"Will you, Senator so-and-so, pledge to live — and to have your family live — under ObamaCare, like ordinary Americans do? Yes or no?"

What conservative interviewers/panel members in the MSM will step up and ask this question of prospective candidates?

If the answer is yes, we have an ally. If the answer is no, why not? What makes you so special, what makes your family better than the families of your constituents, the people you represent?

[TBP]

Tax increases were on the table, until BO demanded even more.