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Freedom-loving Americans are more determined than ever to be rid of the misnamed Patient Protection and Affordable Care Act, knowing as we do that it will neither protect patients nor be in any way affordable. FreedomWorks and other pro-freedom organizations have a simple Five Point Plan for full repeal. The first two of those points call for states to limit the Act's reach. It is important for activists and policy makers to understand these points and be able to explain them to others.
First, governors and legislators should decline to implement the Act's exchange in their state.
The final four points are to decline to expand the state's Medicaid program, and for pro-repeal candidates to win the House, Senate, and Presidency in November. Then, of course, we will have to keep the pressure on our elected officials to pass a full repeal and proceed with reforms that champion patient centered health care and free market principles.
"Let's be clear," Cannon said, explaining the first two points in the plan. "States can't stop Obamacare at their borders, but they can stop certain elements. They can stop large chunks of it, in fact, and if they do it will make eventual repeal that much easier. The two main pieces that states can stop are the state-based exchanges and the Medicaid expansion."
"What they can do," continued Cannon, "is make it very hard for the federal government to implement the law. In fact, they may even be able to make it prohibitively hard. The main way is by refusing to create a health insurance 'Exchange' and by sending all related funds back to Washington. This idea has been endorsed by ALEC and even the erstwhile Exchange supporters at The Heritage Foundation."
States will have little or no control over how the exchanges are run, but will be forced to spend the money to run them. Those funds will be unavailable for other state priorities, and will cause lawmakers considerable pain at budget time. When the exchanges fail to operate smoothly, state policy makers will get the blame at both ends.
At the live blog event, Benjamin Domenech, Senior Research Fellow at the Heartland Institute, said, "As Michael notes, HHS was never prepared for the eventuality that more than a few states would refuse to implement. They are now stuck with a problem they never expected to have, in part thanks to efforts of people like him to inform state legislators of the negative costs of implementation."
Cannon explained the reasoning behind the exchange strategy:
Cannon continued. "Even though the law authorizes the federal government to set up an exchange in states that don't, Congress never authorized any money to create the federal exchanges. They didn't think they'd need it. I don't think the House will authorize any. That might be why the administration is suggesting they will cover start-up costs for up to 6 years."The Obama Administration had decided to treat federal and state exchanges the same for subsidy purposes, regardless of the law.
"At a minimum," Cannon concluded, extending subsidies to federal exchanges without Congressional authority "would present a political problem, even if there are no lawsuits. The IRS is taxing and spending without authorization. They are clearly violating the law."