Should Mississippi establish a health care exchange under the Affordable Care Act? Republican Insurance Commissioner Mike Chaney is creating an exchange while Governor Phil Bryant opposes his actions.
The ACA (Obamacare) gave the states the option of creating their own health care exchanges. The exchange is the workhorse of Obamacare. The exchange will provide on a website the available health insurance plans, prices, and the services provided. If a health insurer isn't listed on the exchange, it will have a hard time staying in business. The law provided funding for the states to create the exchanges. If the state chooses not to establish an exchange, the law states the federal government will create and operate one for the state.
However, many Republican governors such as Bobby Jindal and Scott Walker have refused to set up exchanges. Numerous articles in publications such as The Wall Street Journal, the American Spectator, and others state the law did not provide a means of funding the federal exchanges. The WSJ column stated:
By declining to build exchanges, the states would pass the burden and costs of the exchanges to the administration that sought this law. And it is far from clear that the administration could operate the exchanges on its own.
Congress didn't allocate money for administering federal exchanges, and the law as written seems to prohibit federally run exchanges from providing subsidies to individuals. The administration insists that it can provide those subsidies anyway. But if the courts read the plain words of the statute, then federal exchanges couldn't really function.
Thus states that refuse to create their own exchanges would effectively be repealing a large part of the law.. Column
Needless to say local conservative activists such as Kim Wade have been raising hell on talk radio about Mr. Chaney's actions. It didn't help that the Democratic Trust issued a press release praising Commissioner Chaney for standing up to his own party- a sure-fire way to win Republican friends for a Republican Commissioner Chaney didn't take any criticism lying down and defended his decision in a column published in the Clarion-Ledger Sunday:
"I have stated my opposition to PPACA on many occasions and I hope it is repealed. However, it is the law of the land.
The bottom line is simply this — if we do not implement and operate a state-based health insurance exchange by January 1, 2014, the federal government will implement and operate one for us and we will forever give the keys to health insurance in our state to Washington.
If a state defaults to the federal government to operate an exchange, that state will cede the regulation of a large portion of its health insurance market to the federal government. Consumers could have fewer choices, higher costs in most cases, less benefits and a hard time getting approval for medical services.
Several governors have banded together and decided not to implement state-based exchanges — opting to let Washington operate them instead. They think Washington will not have the ability to operate or fund exchanges. To the contrary, what they are actually doing is helping Washington expedite the takeover of the state health insurance industry. The result is that the states will have no voice and the path will be cleared for the implementation of a single-payer system in this country.
The feds will implement a “one-size fits all” exchange in the state. Washington will decide, among other things, what plans are sold on the exchange, what rates are charged, who may purchase through the exchange, provider networks for the exchange and what role agents will have in the exchange..." Column
Who is right on the creation of health care exchanges remains to be seen. However, there is one flaw in the logic advanced by the WSJ column. The central point of the opposition is the law did not provide funding for federal exchanges- only state-run exchanges can qualify. However, the opponents of Obamacare assume the adminitration will follow the law. The Obama administration will use the "try and stop it" offense and simply take money from another fund and apply it to federal exchanges, the law be damned just as it did on the GM bailout. The Obama administration transferred money from TARP to GM. TARP was never meant to be used to give money to GM and Chrysler but that is what the administration did. The conservatives are hoping the courts will step in and stop the federal government from doing such a thing but in the end, their entire strategy rests on using the courts to stop the federal exchanges. A prospect that is not too certain given the recent Supreme Court decision. The courts never interfered with the misuse of TARP money.
However, the unasked question is what will Governor Bryant do to stop the commissioner. While the Governor has made several public statements opposing the exchanges, he has taken no action to stop the Commissioner. Several conservatives argue the Governor can call a special session to prevent Mississippi from creating an exchange. However, the Governor so far has made no plans to call a special session. Several legislative sources informed this correspondent the votes are simply not there to reverse the commissioner. One of them said it was a great way to put Republicans on the record and see where they really stood. However, he also said there will be no special session for that reason. The commissioner made his move. What move will Governor Bryant make, if any?
Wednesday, November 28, 2012
Obamacare standoff in Mississippi?
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19 comments:
So Phil Bryant, a "champion" of States' Rights, wants the federal government to perform a function that Mississippi can do (and is doing)? This on the basis that the feds won't have the money to do it? If Bryant gets his way, average Mississippians won't have access to a broad range of health insurance options, and will receive no premium subsidy. So, the average guy gets screwed once again by the Republicans. Why a Mississippian of modest means would ever support a Republican is just beyond my comprehension.
Chaney is just than another bought and paid for Insurance Commissioner.
It is going to be a hoot to watch ol' Mike get hit -- smacked -- upside the head with the massive blowback when employers in the state drop the insurance they provide and opt to pay the penalty instead.
The economics of paying the penalties are far too compelling for small employers. Reducing the hours of employees and paying the Obamacare penalties for not providing insurance is going to increase profits.
And what Chaney doesn't tell you is that many Mississippians will also opt out and pay the annual penalty versus purchase insurance from the exchange.
In a low income state like ours people will take the risk because the net income boost, even after paying the penalty, means a lot of extra money in their pockets every year.
The law of unintended consequences is just about to bite Mike Chaney and his puppeteers in their collective asses.
In Dees' world the "average guy" thinks insurance is a piggy bank of free money.
Gov. Bryant using the bully pulpit re: teen pregnancy makes more sense than using his political capital to oppose the Insurance Commissioner. We had a .8% shrinking of the state's economy in FY11 in the poorest state so almost everyone is bleeding economically here. As the state leader the Governor must be very strategic in his signals as he sets the state's course to recovery.
That's the long way around to simply say what you said in your last sentence, which is, "I have a comprehension problem".
Some of the most difficult and frustrating times are transitions to change.
Making the transition to Obamacare can be made easier or harder on the citizens.
Jindal chooses harder on principle and hopes his citizens are also willing to accept the consequences of standing on principle.
Chaney chooses to make the transition easier on the citizenry and chooses duty to them over principle as he sees the " cause" is lost.
Phil hopes to have it both ways.
The political rhetoric on this bill has exaggerated its shortcomings and overplayed its advantages.
Those without coverage through an employer and employers will have some decisions and choices to make.
The rest of us will hardly notice.
Doctors and hospitals will still file and we'll still hand over our cards and get charged the difference.
If our employers made good decisions in shopping companies, we will find we have a bit less out of our checks and a smaller co-pay in Mississippi as we now pay more for less coverage than many other states...even our neighbor Alabama.
Politics has been about getting the bases to over-react and be fearful. My hope that in a couple of years we might remember , for a change, how we were " played".
Everybody gets played except Grandma troll.
"The political rhetoric on this bill has exaggerated its shortcomings and overplayed its advantages."
9:07; What are you privy to that the rest of us in the proletariat haven't been told? HR companies all across America are scrambling to market their versions of what Obamacare might or might not mean to employers, individuals and providers. Meanwhile, you have the secret book of answers. Does your wife realize what a gold mine she has in you?
Shadow, 9:07 is Grandma troll.
Me Hungry for brains...Hope & Change, Hope & Change, Forward, Hope & Change, Hope & Change, me hungry for brains. - The average US Consumer.
I just want to take this opportunity to laugh at the entire dumbfuck Tea Party movement. Put this election in your pipe and smoke it, bitches!
best article on the subj. i am privy to:
http://www.nationalreview.com/articles/334203/constitutional-opening-paul-moreno#
If you people did more homework and absorbed information from both parties.....you would be better informed and your opinions might even be respected.
Rule number one...NOTHING IN LIFE IS FREE. This includeds your OsamaCare.
Shadow, I read the bill
More of the Phil and Chaney Show!! This is really going to get interesting because neither of them know what the hell they are doing! They both want to have it both ways and now they are butting heads! Talk about being in water over your head! It's just unfortunate that the people of Mississippi will be the ones who pay for their mistakes! Will the voters ever learn to vote for and elect candidates who have brains??? Please let's remember this in three years when we go back to elect a governor and insurance commissioner for this state!
This is the last chance for a free market healthcare system to work. We will have former health insurance company employees looking for work in the single payer government-run system if the Affordable Care Act gets stuck in the mud of political failure, professional quibbles, or provider corruption.
Not sure about this. The people who say screw Obamacare are taking a huge risk that the federal government will be unable to operate the exchanges. If they're right it will be impossible to fully implement Obamacare and we'll be stuck with whatever happens after that. If they're wrong then the federal government will have total control over the insurance companies providing coverage in the states that refuse to set up their own exchanges. Big risk...
Bill, it could be that the medical insurance industry will simply be somewhat better regulated.
Don't you remember that bill the industry got through the lame duck Congress right before Clinton came to office when the industry was terrified?
In effect, all mechanisms of verifying information provided to the government by the medical insurance industry were erased. All we know about medical insurance, their costs vs profits, is what they choose to share.
I'm not worried about how the industry will fare. They have achieved zero risk through successful lobbying of many unnoticed bills and regulatory changes over time.
The government will simply have a somewhat better idea by getting the information through the back door of delivery. Still not as good as it once had.
There is only a small hope that with forced competition and over time, better information, rates will be lower.
Think, just think how Medicare reduced the odds of paying out for insurance companies. Everyone over 65 was erased from their books!
74% of people under age 65 are healthy. Only 6 % of people under age 65 die. But, the industry has us believing with examples of the rare, that they can't make a profit on the 74%! They tell us how much they pay out when it's bad, but not how much they've taken in or that it's accumulated...every year the healthy pay and pay and pay and for years, many don't come close to their deductible. And, the industry gets use of the money they don't pay out to invest and if they invest badly, we cover their losses with higher rates.
States are tasked under Obamacare with setting up and running the exchanges. But here’s the kicker: If they don’t, the law can’t work. Thanks to a quirk in the law’s drafting, only state-established exchanges are “valid.” In states that decline to set up an exchange, while the feds can certainly come in and set one up, it will be illegal for that exchange to distribute health insurance premium subsidies to individuals or enforce the employer mandate. In which case, the system stops.
Since Chaney says if Mississippi doesn’t implement and operate the exchange, the feds will do so, what about the quirk in the law’s drafting, saying only state-established exchanges are “valid.” Isn’t it true, that in states that decline to set up an exchange, while the feds can certainly come in and set one up, it will be illegal for that exchange to distribute health insurance premium subsidies to individuals or enforce the employer mandate; and isn’t it true that in which case, the system stops.
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