States rebelling against insurance exchanges

Missouri’s attorney general, Democrat Chris Koster, broke with his party Monday by filing an amicus brief with the 11th U.S. Circuit Court of Appeals in support of the 26-state lawsuit challenging Obamacare’s individual mandate. With Virginia and Oklahoma pursuing their own separate legal actions, Koster’s brief makes Missouri the 29th state to go on record against President Barack Obama’s signature domestic policy accomplishment.

As embarrassing as this might be for the chief executive, he should be even more worried about the havoc his health care plan is creating for governors across the country. The new law authorizes the secretary of the federal Health and Human Services Department to provide grants to states for them to create health insurance exchanges that must conform to yet-to-be-written regulations. The law also authorizes the department chief to establish and run the exchanges unilaterally should any state choose not to create one by Jan. 1, 2014.

This would seem to put governors opposed to the law in a tough bind: Do they accept the federal money and attempt to design an exchange that does the least amount of harm to residents of their states? Or do they defy Obamacare, refuse the money and implement their own consumer-oriented reforms?

That is a false choice. Just look at the history of any federally funded state-run program. Whether it is Medicaid, education or transportation, the pattern is clear: Once states accept funding from the federal government, they quickly become dependent on it and are forever at the mercy of red-tape-happy bureaucrats in Washington, D.C. The Health and Human Services Department will be writing all the rules that govern exchanges, so who actually administers them is largely irrelevant.

So far, only Govs. Sean Parnell, R-Ark., and Tim Pawlenty, R-Minn., have turned down federal money for funding exchanges. That means 48 governors chose to accept the money. They include many with strong conservative track records, such as Haley Barbour of Mississippi, Sam Brownback of Kansas, Mitch Daniels of Indiana, John Kasich of Ohio and Scott Walker of Wisconsin.

But momentum is changing. After Judge Roger Vinson found Obamacare unconstitutional in January, Florida Gov. Rick Scott rejected $2 million in previously awarded federal grants and halted all implementation efforts. On March 16, Gov. Nathan Deal pulled legislation creating Georgia’s exchange system after protests from local tea party groups. And on the anniversary of Obamacare’s passage, Gov. Bobby Jindal announced that Louisiana would pursue its own health care reforms.

Even states with governors sympathetic to the law are finding implementation of the exchanges to be a headache. Sold by the White House as a simple clearinghouse such as Travelocity, the Obamacare exchanges must collect detailed personal information that includes family size, medical history, employment status and personal income. Such information is required to determine the amount of each family’s insurance subsidy. This is yet another reason why the U.S. Supreme Court should not delay in granting Virginia Attorney General Ken Cuccinelli’s request for an expedited review of his state’s challenge of Obamacare’s constitutionality.


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