The RTD’s Bart Hinkle argues that Virginia should in no way, shape or form act as an Obamacre enabler by creating health insurance exchanges. Why?
Any state exchange will have to abide by the Obama administration’s directives. Virginia cannot create a free-market exchange that allows every kind of insurance and coverage plan. (Utah’s exchange, which originally did essentially that, likely will not survive federal scrutiny.) To participate in an exchange, insurers will have to include a variety of mandated benefits. The Department of Health and Human Services has let it be known states can add more mandates than Obamacare requires, or adopt a single-payer system, but they cannot have fewer.
Those mandates will drive up premiums. And high premiums have discouraged consumers in both Utah and Massachusetts from buying policies through those states’ exchanges, even though Massachusetts offers substantial subsidies. (Massachusetts provides “complete” or “substantial” premium subsidies for individuals making up to 300 percent of the poverty level.) An analysis by Georgetown University’s Health Policy Institute, for instance, notes that “high cost was the primary reason for nonparticipation” in Utah, and the Massachusetts exchange “has been unable to meet small employers’ most pressing need: lower insurance prices.”
Last summer, Cato’s Michael Cannon made much the same argument on the RTD’s op-ed page:
Since the law allows the federal government to create an exchange in states that do not, some say Virginia should create its own exchange rather than let Washington run the show. But Obamacare lets Washington commandeer any exchange that falls short of full compliance with Washington’s dictates, so there really is no such thing as a state-run exchange.
Cannon also notes that other states have rejected, for now, the exchange idea:
“Creating any kind of exchange is just throwing a lifeline to an unconstitutional law that’s a disaster for patients, for taxpayers and for businesses,” says Gov. Rick Scott, R-Fla. “We’re not going to do that in Florida.”
Govs. Sean Parnell, R-Alaska, Bobby Jindal, R-La., and Rick Perry, R-Texas, followed suit. Gov. Susana Martinez, R-N.M., has vetoed legislation to create an exchange. Resistance from tea party activists and rank-and-file Republicans has defeated exchange legislation in Arkansas, Georgia, Montana, Missouri, New Hampshire and South Carolina, at least temporarily.
Virginia was the first out of the gate in its fight against Obamacare. Not creating an exchange is just another front in that fight, and one we should not shrink from.
