Bluegrass Beacon: Obamacare’s king and his court
Editor’s note: This column contains revisions from the original version that was released to newspapers prior to the Supreme Court’s King v. Burwell decision. The Supreme Court’s disastrous King v. Burwell decision provides a relevant and timely opportunity for thoughtful Obamacare critics of the “repeal-and-replace” stripe to push President Obama’s administration to return control of health-care policy to where it belongs: the states.
Both do-gooder progressives and squishy conservative-types should remember that bullying states to establish exchanges and individuals not only to purchase health care but also be forced to pay for goods and services they neither want nor use – subsidies or not – is noticeably missing from the Constitution’s enumerated purview of the federal government’s power.
It’s bad enough that Obamacare unconstitutionally expands such reach with its 2,700-page bill and ensuing 11.6 million additional words regulating the policy.
Worse, when Obama’s own law proves inconvenient in his attempt to force all Americans to participate, the president’s pattern is to do what he’s consistently done with the Constitution and even the obvious wishes of the people on myriad matters, including health-care policy: ignore them.
The Supreme Court decided Obama can disregard his own law, which unambiguously limits federal subsidies to health-insurance policies purchased through state-run exchanges.
Still, it’s worth reminding that Obamacare’s genius designers admit they did not include subsidies for Americans purchasing insurance through exchanges established by the feds because they know the Constitution doesn’t empower Washington to force states to establish exchanges.
Instead, they made subsidies available only through state-run exchanges, believing such a policy ploy would result in making it impossible for states to resist the easy money of subsidies dangled in front of both legislators and their constituent-recipients of those benefits.
While Kentucky was one of 13 states and the District of Columbia to take the bait, more than two-thirds of states refused – an indication not only of Obamacare’s unpopularity outside the Beltway but also of just how deep state lawmakers’ concerns run over the reform’s uncontained costs, unknown consequences and uncertain future.
Obama responded by ordering the beloved IRS to issue a regulation providing subsidies for health insurance purchased on federal exchanges, notwithstanding the law that bears his own name.
A significant impact of the court’s unlawful ruling allowing people who purchased insurance through a federally established exchange to receive subsidies is that it also lets the despised mandates requiring employers and individuals to provide and purchase coverage, respectively, to continue – as Obamacare allows such mandates only where subsidies also are permitted.
Had the court ruled against the subsidies, it also would essentially have ended the mandates and caused Obamacare itself to implode.
“They would be pulling the fangs out of Obamacare,” David Adams, a vocal critic of the reform in Kentucky, said.
Even with the court’s ruling, Obama could pressure Congress to “just fix three words” so the coverage of millions through this big-government approach is forever sealed.
However, a study designed by the Leavitt Partners to assist governors and state legislators in developing a productive response to the court’s ruling encourages state policymakers to seize the opportunity and go to Washington – literally – in bipartisan fashion and push the administration to give them the flexibility to “advocate solutions that enhance federalism,” noting that “the administration has not shown great flexibility on ACA implementation affecting states.”
University of Kentucky economist John Garen isn’t overly optimistic about “the present administration” granting waivers that would allow states to try some more innovative health-care and insurance policies.
“But if a group of 15-20 states presents a unified set of waivers, then who knows?” Garen, Ph.D., said.
Kentucky, which subsidizes 70 percent of the 109,000 Kentuckians purchasing insurance through its state exchange known as Kynect, could profit greatly from a return to federalism that allows experiments via interjecting free-market principles into health-care policies in the states, the laboratories of democracy.
More on why and how that can happen in my next column.
Jim Waters is president of the Bluegrass Institute, Kentucky’s free-market think tank. Reach him at jwaters@freedomkentucky.com. Read previously published columns at www.bipps.org.