Government Spending

Virginia Should Fight the Federal Health Care Takeover

If Washington is going to dictate the terms, why should the states foot the bill?

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If you're married to a gambling addict, you don't do him any favors by lending him money or telling the bank you were the one who blew the mortgage at the track. Likewise, Virginia should not enable Washington's addiction to big government, epitomized by the federal takeover of health care, by setting up a state insurance exchange.

State lawmakers across the country are debating whether, and how, to set up such exchanges, which are encouraged by the 2010 federal health-care overhaul, or let the feds do it for them. The exchanges will act as clearinghouses where consumers can compare health insurance policies, a bit like the way you can compare travel deals on Expedia.com.

Here in Virginia, legislators differ on whether the exchange should be an entity unto itself, or an arm of the State Corporation Commission. The correct answer is: neither. Virginia should not set up such an exchange at all. The commonwealth has nothing to gain by doing so, and a lot to lose.

For one thing, the Supreme Court might rule the federal Patient Protection and Affordable Care Act unconstitutional later this year. If so, then the money and effort to create the state exchange will have been wasted. And setting up the large bureaucracy required to run the exchange would cost a lot of money—perhaps tens of millions of dollars.
Utah already has a small exchange that, as Kaiser Health news reported, "accepts any insurers and sets few rules."

Yet it still costs $500,000 a year to operate. The other existing state exchange, in Massachusetts, was established thanks to a certain GOP presidential candidate whose name starts with R and rhymes with Omni. More comprehensive and intrusive than Utah's, it costs $30 million a year.

As Virginia Democrats have argued about some of Gov. Bob McDonnell's transportation proposals, setting up a health-insurance exchange here would steal scarce resources from education, environmental protection, and public safety. Or Virginia could fund the exchange with a surtax on insurers—and drive up premiums as a result.

Of course, the high court might rule in favor of ObamaCare. If that happens, then Virginia can always create an exchange later. But it still shouldn't.

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 non-participation" in Utah, and the Massachusetts exchange "has been unable to meet small employers' most pressing need: lower insurance prices."

What happens if a state creates an exchange that Washington disapproves of? The federal government storms in and takes over. If Washington is going to dictate the terms, why should Virginia foot the bill?

That bill almost certainly will be far higher than anyone has projected, and not just for the exchange. Far from "bending the cost curve down," ObamaCare is likely to drive health-care costs through the roof. This is precisely what happened under RomneyCare in Massachusetts: From 2006 to 2010 the cost of that state's insurance program jumped 42 percent, and a Rand Corporation study found that "in the absence of policy change, health care spending in Massachusetts is projected to nearly double [by] 2020." (So much for Mitt Romney's promise that "the costs of health care will be reduced.")

But at least residents up there are getting better care, right? Wrong. Avoidable emergency-room visits have gone up, not down. More than half the state's doctors are refusing to take any new patients. Waiting times are increasing: In 2011 it took, on average, 41 days to see a Massachusetts OBGYN, a week longer than it took the year before.

ObamaCare could soon produce the same higher costs and poorer service. And it is going to be monstrously difficult to implement. Last month The Washington Post reported there is growing concern that HHS will be unable to launch the federal exchange in time.

Naturally, federal officials would love to sit back and give orders while states like Virginia shoulder the burden—and the cost—and the blame—of a government takeover. Virginia's response to Washington should be: You created this problem, you deal with it

A. Barton Hinkle is a columnist at the Richmond Times-Dispatch, where this article originally appeared.

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  1. Who’s on First?

  2. The Mobile Monster just devoured the NAACP thread! Can no one stop it??!??

    1. I can stop it. I’ll need 20 feet of surgical tubing, a pillowcase, a roll of gorilla tape and a supply of 8″ water balloons filled with food coloring.

      Also the blond weightlifter from last week.

  3. Hinkle’s my kind of people. It’s great to see well-reasoned, fact-filled pieces from my hometown rag! How the RT-D might keep him though is beyond me.

    1. Fuck off, he called RP an isolationist. It still hurts.

      1. Czech you premises; I’m volunteering for Ron Paul.
        Anybody who cuts people off first time something’s said he disagrees with, he’ll end up living in a clapboard shack in the woods like the Unabomber, sweeping his dirt floor and yelling at the birds.

        1. The birds are my friends. They love me and tell me secrets.

          I’ll forgive Hinkle eventually, I just have to whinge about it for at least another week.

  4. Virginia’s response to Washington should be: You created this problem, you deal with it

    I disagree. Virginia’s response should be “What? No, fuck that, we’re not doing it.”

    1. Agreed, but more than that, individual citizens need to adopt the same attitude.

      1. I’m -so- already there.

    2. You say Stupice, I say Early Girl.

  5. Should be quite interesting to see hwo that all works out in the end. WOw.

    http://www.real-time-privacy.tk

  6. Virginia is fighting the Golden Rule here. They’re taking Medicaid bux, so the federal piper gets to call the tune.

    Like statists everywhere, they want it both ways – all the money, none of the strings.

    1. I can stop it. I’ll need 20 feet of surgical betclic tubing, a pillowcase, a roll of gorilla tape and a supply of 8″ water balloons filled with food coloring.

      Also the blond weightlifter from last week.

  7. I work in Massachusetts. When I started my job in 2009, I paid about $800/year for my health insurance through my employer and needed to wait about 3 weeks to see my doctor. Now, I pay $1,100/year and just called for a physical. I have to wait until early March for my appointment.

    Everyone thinks it’s great most of the people in Mass have healthcare, but all it has done is increase my wait time and cost because they subsidize it so much. Governor Patrick is now capping the rate at which companies can raise premiums. We already know what that will do to this screwy market.

  8. Samuel Clemens said ” I have never met a man I could not learn at least one thing from.”

    In science, even failed experiments have value. They don’t tell us what is true or how something works, but they do tell us what doesn’t work or what isn’t true. They eliminate possibilities, thus are powerful problem solving tools.

    Problems arise when proponents of an eliminated possibility become intractable in their advocacy. This is encapsulated in Einstien’s quip that the definition of insanity is doing the same thing over and over and expecting a different result.

    Those intractable are always motivated by emotion or have a hidden agenda. I remember seeing a communist chinese guest on the Johnny Carson show decades ago who briefly debated with an american guest, but I don’t remember who. When the American asked the Chinese if the idea of liberty was appealing to him, the chinese answered yes, but that freedom also meant the freedom to starve.
    I was very young, but it hit me immediately that yes, we in america are free to starve, but we aren’t. The chinese are ( were at that time).

    Socialized Medicine is a failed experiment, one that has been replicated many times over. We had the best medical care in the world. The problems it has/had can all be traced to govt. interference. So now, the guy who sought out marxist professors ( another failed experiment) wants our system socialized. What a fucking moron.

    BTW where is Tony? Shouldnt he be here telling us how getting fucked by Uncle Sam is for our own good?

    1. Getting fucked by Uncle Sam is better than letting the elderly die in line waiting for medical care.

      1. Tony, the elderly are dying in line because Uncle Sam has passed so many laws “helping” the people in line.

        If only liberals could understand regulatory capture and the concept of “incentives”!

        1. Nobody waiting in line to get glasses or hearing aids. Can you imagine other parts of medicine without their regulatory straight jacket?

          1. Yes, laser eye surgery and cosmetic surgery. Rarely covered by insurance, always coming down in price.

      2. Dying while in waiting line for medical care is a feature of national healthcare systems all over the world.

        You know, it just occurred to me why I really hate leftists so much. The way they see it we have to limit growth because “there aren’t enough resources for the Chinese to have ‘our’ standard of living” but somehow there are unlimited resources to give everybody in the world all the modern medical treatment they demand.

        How about this. Let people decide what they want and try to get it for themselves and see who can “afford’ what.

        1. In science, even failed experiments have value. They don’t tell us what is true or how something works, but they do tell us what doesn’t work or what isn’t true. They eliminate bet365 possibilities, thus are powerful problem solving tools.

          BTW where is Tony? Shouldnt he be here telling us how getting fucked by Uncle Sam is for our own good?

      3. Yeah, I don’t want to get fucked by a corporation I can fire or just avoid to begin with, I want my government using my money to fuck me.

        1. In science, even failed experiments have value. They don’t tell us what is true or how something works, but they do tell us what doesn’t work or what isn’t true. They eliminate bet365 b?nus possibilities, thus are powerful problem solving tools.

          Problems arise when proponents of an eliminated possibility become intractable in their advocacy. This is encapsulated in Einstien’s quip that the definition of insanity is doing the same thing over and over and expecting a different result.

    2. Come on, I use the “die in line waiting” line and you guys swallow it hook line & sinker. Get better spoof detectors!

  9. Reason was so much better when Virginia was editor!

  10. “What happens if a state creates an exchange that Washington disapproves of? The federal government storms in and takes over.”

    Will The Federal Insurance Exchange Commission have a SWAT Team?

  11. I really find it pretty interesting how the local government can able to support its constituents but for big states, I can see its logic.

  12. I really like the architecture as well as the discussion here.

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