House Votes to Yank Funding for State-Based Health Exchanges


On Tuesday, the House voted to repeal federal funding doled out to states to build health care exchanges, the government-run insurance marketplaces called for by last year's health care overhaul. According to the Congressional Budget Office, the legislation, if implemented, would save about $14 billion. It's mostly a symbolic gesture; there's no real chance the defunding measure actually becomes law. That's too bad, because it could provide a boost to ObamaCare's opposition.

Via Politico, the best argument against pulling the funding is that doing so would simply give more power to the federal government.

Democrats said the bill would undermine the power of state governments, not enhance it, because exchanges would still exist even if the funding was taken away. Under the law, HHS is supposed to run the exchanges for states that refuse to set them up.

"The exchanges aren't going to go away with this legislation. It just means that the states aren't going to be able to do what they need to do, or they're going to yield to the federal government," said Rep. Frank Pallone (D-N.J.)

This line of thinking should be familiar to those who've been following debates about the exchanges: It very much resembles the argument that states, even those that oppose the health care overhaul, should go ahead and set up their exchanges anyway in order to prevent the federal government from stepping in and taking control of the exchange-creation process. I didn't buy that argument, and, for many of the same reasons, I don't buy this one either. Implementation is foundation building. The more foundation that's built, the harder it is to rip away and start over.

We've already seen the damage early implentation can do to the opposition's case, at least in the courts: After initially ordering implementation on the health care overhaul to stop, Judge Roger Vinson eventually overrode his own order and gave federal and state governments permission to keep working on the law during the appeals process. One reason why? Several states were already working on implementation, and had made it clear they planned to continue. Rather than draw out the issue, Vinson let them go forward. For opponents of last year's health care overhaul, the upshot is clear: Letting the law grow roots now makes it significantly more difficult to pull up later.