Rogue states: the revolt against ObamaCare

Peter Suderman
Reason Magazine
October 2010

…the fiscal punishment that both [Governors] Paterson and Barbour feared was signed into law. Thanks to the unexpected election of GOP upstart Scott Brown to Teddy Kennedy’s old seat in the Senate, which left Democrats for the first time during the Obama administration without a filibuster-proof majority in the upper body—and thus without the ability to pass a revised version of the bill—the House chose to swallow hard and pass the Senate legislation unchanged, making only limited modifications in a follow-up reconciliation bill.

Much of the language that passed into law was never intended to be final; it was more like beta software. Most of the important elements the authors had intended to include were there, but not always in the final intended form. And the code was still crawling with bugs, particularly on the level of implementation: at the states.

But Democrats had heard the call of history. Passing any bill—even a creaky, obviously flawed beta version—was better, party leaders decided, than declaring defeat so tantalizingly close to the finish line. And so, on March 23, 2010, President Barack Obama stepped up to a White House podium to memorialize the signing of the Patient Protection and Affordable Care Act.

As he did, Vice President Joe Biden leaned over and whispered, near a still-hot microphone, “This is a big fucking deal.” As with all the best political gaffes, Biden’s slip of the tongue revealed the truth. ObamaCare dramatically increases state Medicaid burdens at a time when local budgets are in deep crisis, asks states to participate in a woefully underfunded bridge insurance program, and pushes state governments to set up complex health care “exchanges” that must be designed and run according to the administration’s standards—standards it has yet to define and can change at whim. The law is a big deal in every way, and the first institutions to absorb the shock are state governments. That’s why so many have already begun to resist…

…ObamaCare leaves states on the hook for the rest of the tab. On a conference call in early May, officials from the Department of Health and Human Services (HHS) reportedly tried to reassure state officials that they wouldn’t be stuck with the bill. But the HHS has yet to say where the extra money will come from. Against this grim backdrop, 21 states have refused to operate the new insurance pools, leaving their setup and operation to the federal government instead.

In part, states are balking at the idea of being micromanaged by the feds, telling Washington to do the job itself if it can’t butt out of the process. In the words of Grace-Marie Turner, president of the Galen Institute, a nonprofit health care research organization that advocates free-market solutions, “You basically have the states running something in which the federal government is telling them what to run.”…

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