21 governors of the Republican Governors Association sent Health and Human Services Secretary Kathleen Sebelius a letter regarding state participation in exchanges mandated by the Patient Protection and Affordable Care Act (ObamaCare).
In a word, “no”, their states will not participate in something they consider infriges on the Constitution, increases the cost of health care, and “favors dependency over personal responsibility, and will ultimately destroy the private insurance market.”
However, the governors, who felt that the states were slighted in not being part of the solution, said they have the following proposals to help “improve” ObamaCare:
- Provide states with complete flexibility on operating the exchange, most importantly the freedom to decide which licensed insurers are permitted to offer their products
- Waive the bill’s costly mandates and grant states the authority to choose benefit rules that meet the specific needs of their citizens.
- Waive the provisions that discriminate against consumer-driven health plans, such as health savings accounts (HSA’s)
- Provide blanket discretion to individual states if they chose to move non-disabled Medicaid beneficiaries into the exchanges for their insurance coverage without the need of further HHS approval.
- Deliver a comprehensive plan for verifying incomes and subsidy amounts for exchange participants that is not an unfunded mandate but rather fully funded by the federal government and is certified as workable by an independent auditor.
- Commission a new and objective assessment of how many people will end up in the exchanges and on Medicaid in every state as a result of the legislation (including those “offloaded” by employers), and at what potential cost to state governments. The study must be conducted by a neutral third-party research
organization agreed to by the states represented in this letter.
“We hope the Administration will accommodate our states’ individual circumstances and needs, as we believe the PPACA in its current form threatens to destroy our budgets and perpetuate and magnify the most costly aspects of our health care system. While we hope for your endorsement, if you do not agree, we will move forward with our own efforts regardless and HHS should begin making plans to run exchanges under its own auspices.”
Don’t hold your breath.
Interestingly enough, Governor Bob McDonnell did not sign onto this letter, which includes Governors Rick Perry (Texas), Haley Barbour (Mississippi) and Mitch Daniels (Indiana), potential presidntial candidates in 2012, nor did Governor Chris Christie (New Jersey).
Instead, McDonnell sends his own letter and echoes the other governors’ advice over PPACA, but adds that the lack of certainty caused by the “legislative and judicial challenges” means that states must act now on whether to run state exchanges or not. McDonnell sees Virginia’s participation as almost untenable given “skyrocketing Medicaid costs.”
Of note, McDonnell was very clear that he favors the legislative repeal of the bill and applauded the action in the House of Representatives. He said that he and others in Virginia were “disappointed that the Senate failed to take similar action” – a clear signal to both of Virginia’s U.S. Senators Jim Webb and Mark Warner, both Democrats. Webb is up for re-election in 2012 and Warner in 2014 – Warner is a rumored opponent for McDonnell, provided McDonnell doesn’t run for another office earlier.
Read McDonnell’s entire Letter to Secretary Sebelius.
