Understanding #ObamaCare realities, and how states can push back

When Speaker Boehner last week said in the aftermath of the election that ObamaCare was “the law of the land”, it made a lot of conservatives who have fought against the law since then-candidate Obama first proposed it when running for President very angry. And understandably so. Coming off a surprisingly lopsided defeat and still licking their wounds and wondering what the hell went wrong, acknowledging the reality that Congress can do very little about ObamaCare at this point outside of attempting to pick it apart here and there during budgeting negotiations was a bitter pill for many to swallow.

But while it does seem hopeless at this point that anything meaningful can be done against ObamaCare for the foreseeable future in Congress, what’s should be cause for optimism is the power of states to push back on it and push back hard, which would essentially force Congress to address the issue again – perhaps with the power of many of the nation’s Governors … and fed up citizens … supporting them. Cato’s director of health policy studies Michael F. Cannon explains:

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 β€œexchanges.” 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 β€œdeadlines” for implementing REAL ID, which have been pushed back repeatedly since 2008.

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

[…]

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.

[…]

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.

Make sure to read the whole thing. And keep your chins up. It ain’t over. Not by a long shot.

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