On Monday of this week, the Arkansas legislature’s House Committee on Insurance and Commerce voted to recommend passage of House Bill 2138, a bill “to implement federal healthcare reform; and to create the Arkansas health benefits exchange.” The vote was straight party-line: 11 Democrats for, seven Republicans against. HB2138 is expected to be voted on in the full Arkansas House on Wednesday. A similar scenario has been or is currently being played out in virtually every State in the Union.
The Patient Protection and Affordable Care Act (PPACA or “Obamacare”) mandates health care exchanges in each State and allows each State to set up “its own” exchange, strictly along federal guidelines of course.
Here’s the deal: If a State elects to set up its own exchange, by January 1, 2014 it must have “(1) the Federal standards established under subsection (a); Or (2) a State law or regulation that the Secretary determines implements the standards within the State.” If a State fails to establish an exchange that is acceptable to the Secretary of Health and Human Services, then “the Secretary shall (directly or through agreement with a not-for-profit entity) establish and operate such Exchange within the State and the Secretary shall take such actions as are necessary to implement such other requirements.”
States are being told that they must be showing “adequate progress” by January of 2013 to avoid having the federal government begin its takeover of their exchanges.
The bribe: If a State will immediately begin the process of implementing an Obamacare exchange, then the federal government will also immediately start giving the State “federal grants” to cover the State’s implementation expenses.The blackmail: If a State does not implement an Obamacare exchange or acceptable alternative, the federal government will initiate its usurpation of the State’s health insurance regulation.
One can almost be sympathetic to the plight of State legislators in this situation. The federal government is bribing the State with federal grants to expedite a program the majority of Americans inarguably oppose and, at the same time, is blackmailing them with a usurpation of the State’s health insurance regulation if they don’t accept the bride.
Average Americans like myself hear something different than State legislators when we hear “federal grants.” They must be attractive to State legislators since that’s money they don’t have to try to find in a crowded State budget. But when you and I hear “federal grant,” we understand the federal government doesn’t have any money unless it gets it from us. It makes little difference if the money taken from our personal incomes goes through Washington, D.C. or (as in my case) through Little Rock, it all feels the same coming out of our pockets. So we’re not impressed that something will be paid for by a federal grant instead of State funds.
We appreciate the fact that the issue of PPACA and its mandated health insurance exchanges is one that ultimately will be resolved in Washington by the Congress and the Supreme Court. What we don’t appreciate is the enormous waste of our monies (either federal or state) until this issue is resolved.
Why the Rush? Individual States can obviously implement these Obamacare exchanges by using their individual resources in their individual states much more rapidly than Health and Human Services (HHS) can do so in all of the States. So the federal government is doling out “federal grants” to the States to get their implementation processes underway. But why the rush when the constitutionality of the PPACA has not settled and while there is an intense battle raging in Congress to completely repeal and replace Obamacare?
Ronald Reagan answered that question for us when he said, “No government ever voluntarily reduces itself in size. So, governments’ programs, once launched, never disappear. Actually, a government bureau is the nearest thing to eternal life we’ll ever see on this earth.”Here’s the strategy: If Obamacare can be implemented in the States before it’s ruled to be unconstitutional or defunded or repealed by the Congress, Ronald Reagan will once again have been proved to be right. In the rancorous debate over HB2138 in Arkansas, legislators were passionately promised that if the PPACA is found to be unconstitutional or is repealed, HB2138 will “go completely away.” I doubt that even one of them believed it.
What Can Be Done? State legislators can be pressed and encouraged to be men and women of principle and courage and to refuse both the bribe and blackmail of the federal government.
But the real battle is in Congress, where bribes (the federal grants) must be stopped, and the blackmail (usurpation of each State’s sovereign right to regulate its own health insurance industry) must be halted until the Supreme Court can determine the constitutionality of PPACA.
Congress must take immediate steps to eliminate the $105 billion slush fund in advance appropriations tucked inside Obamacare. See the full story about this $105 billion slush fund here.
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PPACA Section 1321: (b) STATE ACTION.—Each State that elects, at such time and
in such manner as the Secretary may prescribe, to apply the requirements described in subsection (a) shall, not later than January 1, 2014, adopt and have in effect—
(1) the Federal standards established under subsection (a);
or
(2) a State law or regulation that the Secretary determines implements the standards within the State.
(c) FAILURE TO ESTABLISH EXCHANGE OR IMPLEMENT REQUIREMENTS.— (1) IN GENERAL.—If—
(A) a State is not an electing State under subsection (b); or
(B) the Secretary determines, on or before January 1, 2013, that an electing State—
(i) will not have any required Exchange operational by January 1, 2014; or
(ii) has not taken the actions the Secretary deter- mines necessary to implement—
(I) the other requirements set forth in the standards under subsection (a); or
(II) the requirements set forth in subtitles A and C and the amendments made by such sub- titles; the Secretary shall (directly or through agreement with a not- for-profit entity) establish and operate such Exchange within the State and the Secretary shall take such actions as are necessary to implement such other requirements.
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Curtis Coleman is the President of The Curtis Coleman Institute for Constitutional Policy and contributing author to the ARRA News Service.
Tags: Curtis Coleman, Institute for Constitutional Policy, Arkansas, exchanges, HB2138, Obamacare, Patient Protection, Affordable Care Act, PPACA, Constitutional Crisis, Health Care Reform, To share or post to your site, click on "Post Link". Please mention / link to the ARRA News Service. Thanks!
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