November 28 2012
Legislate in haste—repent at leisure?
Well, not exactly leisure--more like frantic disarray.
Here is the beginning on a Wall Street Journal piece this morning on the implementation of ObamaCare:
ObamaCare is due to land in a mere 10 months—about 300 days—and the Administration is not even close to ready, so naturally the political and media classes are attacking the Governors and state legislators who decline to help out. Mostly Republicans, they’re facing a torrent of abuse in Washington and pressure from health lobbies at home.
But the real story is that Democrats are reaping the GOP buy-in they earned. Liberals wanted government to re-engineer the entire health-care system and rammed the Affordable Care Act through on a party-line vote, not stopping to wonder whether it would work. Now that implementation is proving to be harder than advertised, they’re blaming the states for not making their jobs easier.
The Affordable Care Act calls for states to set up “exchanges,” large bureaucracies to deal with health insurance in their boundaries. This will be a mammoth, almost certainly undoable job, but states don’t have to do it—legally they can leave the job to the federal government.
Ordinarily, conservatives like to see states handle their own business. But this is a bad law, unworkable in design, so maybe implementing this monstrosity is best left to the people who foisted it upon a largely unreceptive citizenry?
Sixteen states have announced that they will not develop exchanges and eleven are undecided. Six are creating “hybrid” systems that are a mix of state and federal control. HHS thus becomes responsible for perhaps 25 to 30 states.
The Journal notes:
The opposition isn’t so much political as practical. Or rather, the vast logistical and technical undertaking to build an exchange helps explain why so many Governors resisted ObamaCare in the first place.
States have regulated the small business and individual insurance markets for decades (some well, others less so). Now they’re supposed to toss everything out for a complex Washington rewrite, which is still being rewritten. The exchanges will also help enforce the individual mandate and premium increases. They’ll also have to spend a ton of money. Ohio estimates it will cost $63 million to set up an exchange and $43 million to run annually, based on a KPMG study.
I also like this succinct description:
The main problem is that states are being conscripted as federal contractors.
Insurance companies have been vilified by the administration, while at the same time the White House was extremely receptive to their desires. The Affordable Care Act contains many goodies for these companies and the big hospitals, also favored in the legislation.
According to the Journal piece, these lobbies are even more powerful at the state level and saw state-designed exchanges as easier to manipulate. I can’t help thinking that the decision by some governors to let the feds handle the whole mess, which these companies don’t want, is justice.
The day after ObamaCare passed, we invoked the “Pottery Barn” rule that Colin Powell once applied to Iraq: You break it, you own it. Washington is about to break it, and the states are saying they won’t be accomplices.