Having utterly failed to convince the American people to embrace Obamacare, and facing a steadfast House of Representatives that has passed a bill to repeal Obamacare by a margin of 56 votes, the Obama administration — always probing for weakness — is now testing the resolve of Republican governors. So far, the verdict is mixed.
For months, the administration has been reaching out to GOP governors and trying to convince them to work with administration officials to implement Obamacare. Specifically, President Obama and Health and Human Services secretary Kathleen Sebelius want states to implement Obamacare’s “exchanges,” the government-controlled points of access to health care that — if Obamacare isn’t repealed — would become essentially the only place where one could buy insurance that isn’t provided by an employer. The Congressional Budget Office (CBO) has estimated that a cool $1.0 trillion of Americans’ tax dollars would funnel into these exchanges, and thus to private insurance companies, during Obamacare’s real first dozen years (2014 to 2025).
President Obama and Secretary Sebelius can’t implement these exchanges until 2014 (if Obama is reelected), but they’d like the states to move forward now. So they are offering the appearance of flexibility in the attempt to lure the governors into an unlikely alliance. If Republican governors take the bait, they will be helping to undermine the cause of repeal in three separate but interconnected ways: They will give the citizenry the impression that Republicans aren’t as determined to pursue repeal as Obama and the Democratic Congress were to impose this monstrosity; they will give Obama the chance to talk about how flexible and bipartisan 2,700 pages of mandates and regulations — passed without a single Republican vote — can be; and they will cause the Republican Party to acquire partial ownership of Obamacare.
Sebelius, in particular, has been actively courting Republican governors. In mid-December, she wrote at healthcare.gov (just type “Obamacare” into a search engine, and a sponsored link to that site, paid for with your tax dollars, will come up) that HHS will “work” with states to “provide the support they need to help turn the health care law into a reality.” And she promised to grant states the “flexibility” to implement Obamacare “in the way that works best for them.”
This week, President Obama followed suit. Speaking to the National Governors Association in the White House State Dining Room, he endorsed a proposal that has been advanced by two Democratic senators and Republican senator Scott Brown, which would allow states to ask HHS for permission to opt out of various Obamacare mandates in 2014 rather than 2017. But the proposal is essentially meaningless, and the only real purpose it serves is to allow the administration to appear flexible while remaining recalcitrant.
Needless to say, Obamacare wasn’t written in such a way that states could escape its grasp in 2017, and they wouldn’t be able to escape it any better in 2014. As former HHS secretary Mike Leavitt told the Washington Post, Obama essentially told the governors, “We'll give you permission to ask for permission sooner rather than later.” No governor would be given permission to pursue different goals than the administration’s — such as the goal of lowering health costs (by letting Americans have greater control over their own health-care dollars, spurring completion in the marketplace, and reining in trial lawyers), for example.
Indeed, seemingly in complete denial, Obama told the governors, “[T]he fact is, that the Affordable Care Act [Obamacare] has done more to rein in rising costs, make sure everyone can buy insurance, and attack the federal deficit than we’ve seen in years. And that’s not just my opinion; that’s the opinion of the Congressional Budget Office.”
But here’s what the CBO really had to say about Obamacare’s effect on health costs: “[T]he average premium per person covered (including dependents) for new nongroup policies would be about 10 percent to 13 percent higher in 2016 than the average premium for nongroup coverage in that same year under current [pre-Obamacare] law….Average premiums per policy in the nongroup market in 2016 would be roughly $5,800 for single policies and $15,200 for family policies under the proposal, compared with roughly $5,500 for single policies and $13,100 for family policies under current [pre-Obamacare] law.”
And here’s what Obama’s own Medicare chief actuary has had to say about Obamacare’s effect on health costs, in relation to pre-Obamacare law, from 2010 to 2019: “[W]e estimate that overall national health expenditures under the health reform act would increase by a total of $311 billion.”
Obama proceeded to praise Mitt Romney’s efforts in Massachusetts. And then, in the wake of having used every heavy-handed trick in the book to ram through highly unpopular legislation that would do more to centralize and consolidate power in Washington than any other piece of legislation in our nation’s history, he actually said this: “You see, part of the genius of our Founders was the establishment of a federal system in which each of our states serves as a laboratory for our democracy.” The word “shameless” doesn’t even begin to describe it.
Yuval Levin writes that Obama’s proposal “allows no flexibility regarding ends, and therefore very little flexibility regarding means. In fact, while it would allow conservative-leaning governors essentially no freedom to move in the direction of greater competition and more consumer-driven health care (which conservatives tend to see as the actual path to reducing costs and therefore insuring more people while improving quality) it would give liberal-leaning governors significant freedom to move in the direction of more government control.”
Supporting that contention, the Washington Post writes, “In Vermont, Gov. Peter Shumlin, a Democrat, is exploring the idea of using a waiver to create a so-called single-payer system, a government-run health care plan.” The Post adds, “Such a plan, dubbed the public option in last year’s health care debate, would never have passed Congress.”
In truth, President Obama conveyed everything that one could hope to know about the limits of his proposed “flexibility” when he made the following remark to the governors: “I am not open to re-fighting the battles of the last two years, or undoing the progress that we’ve made.” In other words, the condition of his flexibility is their acceptance of Obamacare.
Obama’s insincere proposal, which would require legislative action, will go nowhere. As the New York Times writes, “House Republican leaders said Monday that they were committed to repealing the law, not amending it.” But the response from governors thus far hasn’t been so clear or firm. Politico reports that there was “a surprisingly positive reaction from Republican governors” in the wake of the speech, quoting Utah governor Gary Herbert and Oklahoma governor Mary Fallin. Herbert called the president's speech a “step in the right direction,” saying, “I'm hopeful it's going to lead [to] better discussions of understanding about flexibility.” And Fallin said, “I was encouraged that there seemed to be some movement to talk about the possibility of allowing states more flexibility.”
This isn’t the first time that GOP governors’ remarks have failed to inspire much confidence. Three weeks ago, Indiana governor Mitch Daniels and 20 other Republican governors issued a list of “exchange”-related demands to Secretary Sebelius. In a high-profile Wall Street Journal op-ed, Daniels wrote that, subject to these demands, if Secretary Sebelius “wants Indiana to run [the administration’s] program for it, we will do so.”
Those demands did not include keeping one cent of the $1 trillion in taxpayer money from funneling into the “exchanges,” or eliminating Obamacare’s “individual mandate” — its requirement that Americans buy federally approved health insurance under penalty of law — which two federal district judges have (and had at that time) struck down as unconstitutional. Moreover, even though his piece focused entirely on Obamacare, Daniels never once used the word “repeal” or any of its derivatives (or, for that matter, the word “Obamacare” — although the Journal’s editors did, in the title). Instead, Daniels inexplicably wrote, “Many of us governors are hoping for either a judicial or legislative rescue from this impending disaster…But we can’t count on a miracle.”
Other governors, however, have struck a more determined tone. Emerging from having heard Obama’s speech, Texas governor Rick Perry said, “Pretty much all he did was reset the clock on what many of us consider to be a ticking time bomb.” South Carolina governor Nikki Haley declared, “It’s not good enough.” She added, “He is still not letting states decide what is best for them. The bottom line is that under his plan, people will drop off private insurance plans from employers and add on to public rolls. That’s not reducing heath care costs; that’s increasing costs. That’s not increasing the quality of health care; that’s decreasing it.”
Hopefully more Republican governors will follow the example of Haley, Perry, and the House of Representatives, and realize that, when it comes to Obamacare, there is only one course of action worth pursuing. That course doesn’t require a miracle. It merely requires some willpower and some determination to lead.