Will multiple states’ non-cooperation be too much for ObamaCare?

posted at 6:01 pm on November 12, 2012 by Erika Johnsen

The answer, of course, is an emphatic yes, since by its very nature, ObamaCare is too much for ObamaCare, but individual states’ freedom to opt out of designing their own state-specific health insurance exchanges is turning out to be yet another flaw in the oh-so-masterful plan.

Last week, Health and Human Services Secretary Kathleen Sebelius announced that the government is extending the deadline by which states must submit their blueprints for their exchanges, meant to be tools with which consumers can shop around for insurance options, but all states must still indicate whether they’re planning on doing it themselves, forging a partnership with the feds, or letting the federal government do it for them, by this Friday.

Certain states have been wrestling with the decision — to try and do the best they can for their state with the new normal, or let the federal government lie in the bed it made for itself? Phil Klein, among others, thinks that states shouldn’t acquiesce; Washington is going to end up making all of the really important decisions anyway, so why even invite the appearance that the states have any meaningful control over what’s going on or take any of the pressure off the feds? Several states have declared flat-out that they will not be participating, and there are plenty more with misgivings — seventeen states or more may end up fully relying on Washington for their exchanges.

Which could be kind of a major problem for the federal government; WaPo has the skinny on how much work it is to set up these insurance exchanges, and if the federal government has to manage all this… that’s a lot of bureaucrats.

“These are systems that typically take two or three years to build,” says Kevin Walsh, managing director of insurance exchange services at Xerox. “The last time I looked at the calendar, that’s not what we’re working with.” …

These marketplaces often get described as a Travelocity or Expedia for health benefits. While that might be the case for the consumer experience, experts say the underlying technology is hugely more complex, a maze of interconnecting computer systems meant to deliver health insurance to 30 million Americans.

“The reality is, states and the federal government are building something new,” says Pat Howard, who runs state health issues for consulting firm Deloitte. “There’s a rough blueprint in terms of federal regulations, but there’s still a number of decisions that need to happen to operationalize this.”

I fear that this will not end well. …So, nothing out of the ordinary.


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Most idiotic idea already proven VERY WRONG by USSR, Cuba, North Korea and others.

riddick

You don’t even have to go that far. It’s been proven wrong right here at home. I mean, you can only laugh at a moron like HAL who is so pathetically clueless and so detached from reality that he believes a government that is $16 trillion in debt and that is running trillion dollar annual budget deficits would know anything about keeping costs down.

xblade on November 12, 2012 at 7:56 PM

I heard a commenter today say if the state refuses to set up an exchange and the feds have to do it, employers will not have to contribute to it. Or something like that. When they wrote it they forgot to include it.

They gave the rule #, but can’t remember it. It would really hurt obamacare.
Will try to get exact info.

Barred on November 12, 2012 at 7:33 PM

Very true. We’re in NV and if HusseinCare is to be implemented here we are ready to move to a state where it will not be. A number of states will not be implementing this idiocy, remains to be seen how communist states of America go it alone and make it a success. Not that I don’t know the results already after having hands on experience with that in USSR. This will not be pretty.

riddick on November 12, 2012 at 7:58 PM

Latest is that Florida, having stood up against this all year, is now talking about caving in. Perhaps its just Tallahassee’s acceptance that Florida is becoming more and more left wing with the continuing migration of Northerners into our state. These “good folks” come down looking for warm weather and bring the same ridiculous liberal ideas that destroyed the Northeastern states.

clippermiami on November 12, 2012 at 6:18 PM

This surprises me. In 2009, Rick Scott, before he became your governor, put $5 million of his own money to start CPR, Conservatives for Patients Rights, to fight Obamacare. If the decision is solely his, he won’t do anything to help install this POS. Sounds like he might be dealing with wobblies around him, but he’s not one of them, trust me.

parteagirl on November 12, 2012 at 8:00 PM

Its time to roll out the single payer. This is the best way to control cost and ensure all Americans are getting the best health care available to them.
With the new mandate Americans gave Obama on Tuesday, hopefully this can happen asap. America needs it.
HotAirLib on November 12, 2012 at 6:51 PM

Who the fluke are you to determine what is best for me and my family? GTFO you fascist!

jawkneemusic on November 12, 2012 at 8:01 PM

Its time to roll out the single payer. This is the best way to control cost and ensure all Americans are getting the best health care available to them.

HotAirLib on November 12, 2012 at 6:51 PM

LOL! I’m British by birth. We have single-payer. We also have some of the worst cardiac and cancer survival rates in the developed world.

In addition to universal healthcare, we also have universal dental care. Now, put on your thinking cap and tell me:

How many jokes (ballpark) about British teeth have you heard in your lifetime?

Hell, even Darth Cheney’s Zeal Team 6 on Planet Z in Galaxy A0275M^3 ROTFLTFAO about the condition of British teeth.

REPORT: BRITISH CLONES WILL STILL HAVE BAD TEETH

British scientists said on Wednesday they had been granted permission to clone human embryos for medical research, but a report from the journal Nature concluded that cloned humans from Britain would still suffer from poor dental health. Researchers at the University of Newcastle in northern England acknowledged the problem, but asserted that at least their clones wouldn’t suffer from excessive body hair like French clones.

Resist We Much on November 12, 2012 at 8:01 PM

With the new mandate Americans gave Obama on Tuesday, hopefully this can happen asap. America needs it.

HotAirLib on November 12, 2012 at 6:51 PM

Mandate????? Side-splitter! He has NO mandate.

Obama is truly historic. He became the first President to win reelection with fewer EVs, popular votes, states and percentages in American history. Sheesh, HAL, that pig, Andrew Jackson, even beat Henry Clay by a larger margin (56% to 43.6%). Obama/Romney was 51%-48%.

No mandate and, if you want to claim he has one, then the Republicans in the House can and should do the same.

Resist We Much on November 12, 2012 at 8:08 PM

I want big Bertha with the gold teeth at the DMV to give me my annual exam.

/Ugh. Medicaid here I come. My rates just went up 30%. Yay, Obama, yay Obama! Puke.

P.S. You guys aren’t exempt either, so… there’s that.

Key West Reader on November 12, 2012 at 8:13 PM

Its time to roll out the single payer. This is the best way to control cost and ensure all Americans are getting the best health care available to them.

HotAirLib on November 12, 2012 at 6:51 PM

So you seem to LIKE the idea of federal government employees expoloring your nether regions?

Good luck with that. Always knew you were sorta kinky. In case you don’t understand, physicians are opting out on their own. They will no longer take Medicare patients or Medicaid patients, then off you go to the government mandated “health center” of “your choice”. Liberal logic is an oxymoron.

/Blah.

Key West Reader on November 12, 2012 at 8:18 PM

I’m interested to see if anything comes of the several states with petitions to leave the union. I think Texas might be the only state that might be serious. That’s another way out of Obamacare. I read that they already have enough signatures.

Dan_Yul on November 12, 2012 at 8:21 PM

My sister-in-law is a member of one of CAN’s major orchestras. Some years ago their conductor-maybe he was a guest conductor-slipped from his spot in front of the podium and hit his head. He was elderly. He was taken to the local ER and had to wait five hours before he was seen by a doctor. Five hours. At the hospital ER near me, a senior w/a head injury would be seen immediately.

annoyinglittletwerp on November 12, 2012 at 7:48 PM

I am not surprised. I’ve heard and witnessed similar stories.

The family doctors really do their best, but they are victims of the system, as well.

At the time when everybody in the US was laughing about Palin’s “death panels”, the Fraser Health authorities in British Columbia stopped health programs for seniors and the mentally ill. The most vulnerable members of society always suffer first.

Gelsomina on November 12, 2012 at 8:29 PM

Paraphrasing Jefferson for clarity:

“If people let the government decide what foods they eat and what medicines they take, their bodies will soon be in as sorry a state as are the souls of those who live under tyranny.”

DrDeano on November 12, 2012 at 8:45 PM

No part of Socialism can ever be optional.

That’s the whole point of it.

logis on November 12, 2012 at 8:45 PM

Its time to roll out the single payer. This is the best way to control cost and ensure all Americans are getting the best health care available to them.

HotAirLib on November 12, 2012 at 6:51 PM

d##n you’re stupid.

AZfederalist on November 12, 2012 at 8:48 PM

I heard a commenter today say if the state refuses to set up an exchange and the feds have to do it, employers will not have to contribute to it. Or something like that. When they wrote it they forgot to include it.

They gave the rule #, but can’t remember it. It would really hurt obamacare.
Will try to get exact info.

Barred on November 12, 2012 at 7:33 PM

Very true. We’re in NV and if HusseinCare is to be implemented here we are ready to move to a state where it will not be. A number of states will not be implementing this idiocy, remains to be seen how communist states of America go it alone and make it a success. Not that I don’t know the results already after having hands on experience with that in USSR. This will not be pretty.

riddick on November 12, 2012 at 7:58 PM

It was definitely an error made by the democratics in hastily assembling the odious Obamacare. Not a simple typo, but a strategic error. I am sure the democratics would dearly love to patch that hole, and will try to do so in 2013 through trickery and manipulation. That’s one of the things the House has to hold tough on.

slickwillie2001 on November 12, 2012 at 9:00 PM

Anyone here watched BSG, the re-imagined series on Scy-Fy??

After reading this post and the news articles, I am reminded of the scene in that show when the Cylons came in and took over New Caprica, and kept Baltar around to be the little puppet head for the humans while the cylons ran everything.

If the states join up with the Feds on this, they will be the “Baltars”, while the Feds will be the Cylons. :D

MityMaxx on November 12, 2012 at 9:05 PM

This gaping hole in the legislation was not an error but rather it was specifically inserted by Senator Max Baucus to punish states which chose to not set up the Exchanges. It makes individuals only eligible for a tax credit if they buy their insurance through a State-created Exchange, not a federal one. Thus, following the model used for Medicaid and the Clean Air Act, Obamacare was written to promise financial incentives to states that chose to comply, and to prescribe federal “fall-back” exchanges to operate in states that did not.

According to section 1311 of the Affordable Care Act (ACA) the Secretary of the Treasury is authorized to issue refundable “premium assistance tax credits” through Exchanges “established by a state under Section 1311.”. By contrast, there is NO provision for the Federal government to make essential subsidy payments to Federally established exchanges. Thus, if a state declines to set up their own exchanges, the essential linchpin of Obamacare, the federal tax credits and subsidies for individuals to be able to purchase the insurance, collapses.

Section 1401 also, explicitly, limits those tax credits to purchases made in exchanges established under the act’s section 1311 — which requires that exchanges must be “a governmental agency or nonprofit entity that is established by a State.” So, repeatedly in the law’s text, Congress made the state-created exchanges — and not the federal exchanges — the only exchanges where individuals and businesses could get federal insurance subsidies and tax credits.

Most importantly though is these subsidy and tax credit entitlements are what trigger the financial penalties imposed on employers who decline to comply with the Obamacare law. But, if a state does not create the exchange and no available mechanism for the tax credits or subsidies exists, then there also is then no mechanism for penalties to be assessed on business owners who do not comply with the law, which can be as high as $3,000 per employee. Thus, the most damaging part of the law to business owners disappears and states that did not create the Exchanges will be competing for businesses to move from the states that did.

I would encourage everyone to contact Governor Deal with your opposition to the creation of Georgia State health care Exchange.

Here are links to supporting evidence and MUST READ articles on this matter:

The CATO Institute
The Illegal IRS Rule to Increase Taxes & Spending under ObamaCare
by Michael F. Cannon and Jonathan H. Adler
Committee on Oversight and Reform
United States House of Representatives
This testimony was delivered on August 2, 2012.
http://www.cato.org/publications/congressional-testimony/illegal-irs-rule-increase-taxes-spending-under-obamacare-1

Erick Erickson – RedState, Nov. 11, 2012
“We will not support the re-election of any Republican Governor who creates a healthcare exchange in his or her state. Further, we will oppose for the nomination to the Presidency, any Republican who creates a healthcare exchange in his or her state”
http://www.redstate.com/2012/11/11/dear-conservative-organizations/

Letter dated June 29, 2012 to the National Governors Association signed by 12 U.S. Senators, including Jim Demint (R-SC), and 61 Congressional Representatives opposing creation of any State health care Exchanges.
http://bachmann.house.gov/uploadedfiles/congresslettertonga_062912.pdf

jstjoan on November 12, 2012 at 9:09 PM

MityMaxx on November 12, 2012 at 9:05 PM

How ’bout we stick with the real world?

Vichy works.

cozmo on November 12, 2012 at 9:10 PM

Its time to roll out the single payer. This is the best way to control cost and ensure all Americans are getting the best health care available to them.
With the new mandate Americans gave Obama on Tuesday, hopefully this can happen asap. America needs it.
HotAirLib on November 12, 2012 at 6:51 PM

God help you, you’re an idiot. No, that’s not quite it – you’re an imbecile. A sub-moronic, lunatic, incapable of observation or critical thinking skills. Undoubtedly an adult at one point or another warned you about touching a hot stove, but you did it anyway. And again. And then again. You’re probably still doing it, if your commentary is any indication of how truly pathetically hopelessly bereft of any smidgen of a sign of a hint or rumor of intelligent thought or learning capability on your part.

Midas on November 12, 2012 at 9:48 PM

That’s one of the things the House has to hold tough on.

slickwillie2001 on November 12, 2012 at 9:00 PM

ROFLMAO, HAHAHHhahhaaha…

Wait, you’re serious?

Midas on November 12, 2012 at 9:50 PM

I’m interested to see if anything comes of the several states with petitions to leave the union. I think Texas might be the only state that might be serious. That’s another way out of Obamacare. I read that they already have enough signatures.

Dan_Yul on November 12, 2012 at 8:21 PM

We do.

Feel free to borrow from Davy Crockett;,“You can all go to hell…I’m going to Texas.”

Midas on November 12, 2012 at 9:56 PM

@cozmo on November 12, 2012 at 9:10 PM

:D
I live in the real world constantly….
I like to escape every once in a while.

After what I saw happen last week, I am a little sick of the real world for a bit.

MityMaxx on November 12, 2012 at 10:13 PM

MityMaxx on November 12, 2012 at 10:13 PM

Me too, but I liked the reimagined BSG. After being prepared to hate it. I even accepted the girl Starbuck and boring, streamlined battlestar.

I sure wouldn’t want to attach it to anything about this administration.

cozmo on November 12, 2012 at 10:19 PM

@cozmo on November 12, 2012 at 10:19 PM

Yeah, Galactica was more stream-lined…
But Pegasus was not so much.

But the Baltar admin is a lot like the Obama Admin.

Egotistical, narcissistic, etc…

MityMaxx on November 12, 2012 at 10:25 PM

MityMaxx on November 12, 2012 at 10:25 PM

Don’t go badmouthin’ the beast now. I made a few grand by having the first kit available of that.

cozmo on November 12, 2012 at 10:37 PM

LOL! I’m British by birth. We have single-payer. We also have some of the worst cardiac and cancer survival rates in the developed world.

When we finally wake up, we will fully realize that that is their #1 goal and the channel to saving money, which was, if you recall, the very purpose for instituting Obamacare. They just neglected to tell us how thewy would cover illegals and still provide care for all–they won’t and they never intended to.
With todaay’s medical schools lacking ethics training and God having been officially tossed out of America–expect modern Holland or pre-war Germany to be the master plan.

Don L on November 13, 2012 at 6:21 AM

Erick Erickson said yesterday that, in addition to the logistical problem, the law is written in such a way that if the federal government sets up the exchanges rather than the states, then employers cannot be taxed for not providing health insurance to its employees. Without those tax revenues, Obamacare goes belly up and broke.

kclibby on November 13, 2012 at 7:42 AM

With todaay’s medical schools lacking ethics moral training and God having been officially tossed out of America–expect modern Holland or pre-war Germany to be the master plan.

There, FIFY.

This word ‘ethics’ is a very dangerous one, beloved by leftists, who we all know are devoid of anything approaching morality or any rules.

avgjo on November 13, 2012 at 8:46 AM

I kinda like this guy’s approach…

affenhauer on November 13, 2012 at 11:15 AM

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