Ryan Streeter
Indiana Governor Mitch Daniels opinion piece on ObamaCare’s effect on states in today’s Wall Street Journal is likely to get passed around and discussed a lot over the next few days. It’s another example of why so many think he’s one of the best governors – if not the best – in America.
It’s principled and original. And it brings to the public debate some elements about ObamaCare that many readers haven’t probably thought much about.
Many have heard about the individual mandate and the increase in Medicaid costs states will have to bear. But there are two additional realities that Daniels bring to light that haven’t been discussed as much:
ObamaCare will subsidize middle class health care faster and to a larger degree than we expect because of what’s going on in the states.
It will lead to a de facto government takeover of health care faster than most people realize, and as millions of Americans are added to the Medicaid rolls and millions more employees (including, watch for this, workers of bankrupt state governments) are dumped into the new exchanges.
ObamaCare decentralizes its takeover of health care to states in a way that adds costs but which isn’t fully funded – which is a set-up for failure.
The “law expects to conscript the states as its agents in its takeover of health care. It assumes that we will set up and operate its new insurance ‘exchanges’ for it, using our current welfare apparatuses to do the numbingly complex work of figuring out who is eligible for its subsidies…”
These two realities portend grave fiscal burdens to already-strapped states.
Daniels has written a letter, which 20 other states have also signed, to HHS Secretary Kathleen Sebelius requesting:
- The ability to choose which insurers operate in a state
- The power to waive mandates and the prohibition on health savings accounts
- New ways to prevent millions of people being forced into Medicaid, which will cripple states further
- Reimbursement for the full costs of implementation
Here’s to hoping repeal happens before all the requirements kick in. But, as Daniels writes, governors have to make plans as if the law will be in place.
He closes by noting “If there's to be a train wreck, we governors would rather be spectators than conductors.”
I'm pessimistic that Sebelius will do anything other than keep the governors behind the engine's controls. But if the governors make enough noise, the administration might relent. They won't want the already-unpopular provisions to gain more company in the public's mind.
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