Fix Health Care Policy

On Monday Politico ran a column by Sen. Ron Wyden (D-Ore.) taking issue with my critique of his proposal to accelerate the granting of waivers under Obamacare. Unfortunately, he missed a central point I was making about limitations on the waivers that could be granted.

Apparently the senator was offended by this paragraph, from my New England Journal of Medicine piece on his bill:

Even more problematic to proponents of state flexibility on both the left and the right is that states would not be able to fold other health programs into their waiver request. Liberal skeptics at the Physicians for a National Health Program, for instance, point out that provisions of Medicare, Medicaid, the State Children’s Health Insurance Program (SCHIP), Taft–Hartley plans, and other programs could not be waived, leaving large obstacles in the path of a potential single-payer system. And on the other hand, by leaving Medicaid intact, including the required expansion of the program under the ACA, Wyden–Brown does little to comfort conservatives who envision a privatized voucher approach. (Read the rest at The Foundry…)

Tags: ObamaCare, Politico, state flexibility, Wyden-Brown bill

Yesterday President Obama announced support for the “Empowering States to Innovate Act” authored by Senators Ron Wyden (D-OR) and Scott Brown (R-MA). The Wyden-Brown proposal would advance the enactment date of an Obamacare provision that allows states to pursue alternative routes to reform if they can meet the same targets as the President’s overhaul. Though touted by Secretary of Health and Human Services Kathleen Sebelius as “another crucial step in empowering states to lead,” the proposal would fail to deliver the level of flexibility states need to achieve successful health care reform.

Members on both sides of the aisle admit that states’ health care reform needs are vastly different and cannot be addressed by a one-size-fits-all approach like Obamacare, which imposes a pre-ordained federal version of reform on the states. A group of 29 Republican governors has written to the White House to demand greater flexibility to innovate, and even some governors on the left have quietly made the same appeal. But as Heritage expert Stuart Butler warns, Wyden-Brown won’t do the trick. (Read the rest at The Foundry…)

Tags: HHS Secretary Kathleen Sebelius, ObamaCare, one-size-fits-all, state flexibility, Wyden-Brown bill

Speaking to the National Governors Association at the White House today, President Barack Obama endorsed legislation by Sens. Ron Wyden (D-OR) and Scott Brown (R-MA) that would allow states to request waivers from some Obamacare mandates in 2014 instead of the existing 2017 date. President Obama claimed: “It will give you flexibility more quickly while still guaranteeing the American people reform.” Has President Obama even read the legislation? Because that is just plan false. Heritage Foundation Center for Policy Innovation Director Stuart Butler explained in the New England Journal of Medicine:

One [problem] is that it still locks the states into guaranteeing a generous and costly level of benefits. True, a state could propose alternative benefit requirements if they had the same actuarial value as those in the ACA. But the requirements go well beyond basic coverage, and the HHS secretary is the one who defines “at least as comprehensive” benefits. (Read the rest at The Foundry…)

Tags: HHS Secretary Kathleen Sebelius, Obamacare waivers, state flexibility, Wyden-Brown bill

States have a lot to lose under Obamacare. Beyond representing a huge overreach of Congress’s constitutional authority, the new law includes several provisions that restrict states’ ability to reform their health care systems in ways that best serve residents’ specific needs.

Obamacare requires all states to extend eligibility for Medicaid to an additional 18 million citizens. This will have serious implications for state budgets, which are already stretched thin by the cost of the program.

The law also requires that states set up health insurance exchanges, for which the rules and regulations will be defined by the federal government. Indiana Governor Mitch Daniels writes that Washington “assumes that [states] 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, how much each person or family is eligible for, redetermining this eligibility regularly, and more. Then, we are supposed to oversee all the insurance plans in the exchanges for compliance with Washington’s dictates about terms and prices.” (Read the rest at The Foundry…)

Tags: Indiana Gov. Mitch Daniels, Medicaid, ObamaCare, state budgets, Wyden-Brown bill