ObamaCare Battlefront Shifts to the States

Published December 18, 2012

Throughout the debate over ObamaCare—and back to HillaryCare and beyond—the fundamental question in health reform has always been this: Who will control our choices—government or individuals?  

Each side has won battles over the last 15 years in the tug of war between those who want a system that empowers the individual and one that cedes more and more authority to the state.

But when ObamaCare was slammed through in 2010, we took a screeching left turn toward government control even as citizens marched in the streets and more than 100,000 people called Congress every hour pleading that their representatives vote no.

ObamaCare gives only passing lip service to markets and individual choice and did not win a single Republican vote when it passed. Even after passage, most Americans continue to oppose the law which they correctly understand will lead to a government-run health care system. Last month, the Kaiser Family Foundation found only 38 percent of those polled support the health care law. Exit polls on Election Day found 49 percent of voters wanted all or part of the law repealed, and only 42 percent supported keeping or expanding it—millions fewer than voted to reelect President Obama.

Those who support government control have leveraged their considerable resources for decades: in left-leaning think tank studies and billionaire-funded activist organizations, and even taxpayer dollars have been directly spent by HHS to promote ObamaCare and a government-controlled system. But despite being vastly outnumbered and outspent, the free-market health care policy community has been able to explain to the American people what ObamaCare really would do in its Rube Goldberg complexity and collectivism to take away our freedom. And that should give us hope for the future.

Electoral Backlash

The 2010 elections were a resounding referendum on ObamaCare, a backlash that elected 63 Republicans to the House and six in the Senate, blocking any chance the Obama administration could get more liberal legislation passed.

The Supreme Court decision was the next chance to stop at least some of the law, with major demonstrations outside the court during oral arguments and again three months later when Chief Justice John Roberts handed down his tortured, majority-of-one decision that let the law stand. His decision gave ObamaCare a veneer of legitimacy, and the opposition temporarily calmed as a few popular provisions took effect but before the mandates and avalanche of regulations are released that will more fully reveal the cost and intrusiveness of the law.

In early 2012, ObamaCare was a major issue in the Republican presidential primary contests, with the front-runner facing repeated challenges over RomneyCare.

With Gov. Romney leading the ticket, the voters didn’t have a clear choice over the central question of government vs individual control over health care. Romney was unable to focus on the most despised part of ObamaCare—the individual mandate—because he had backed a similar mandate in Massachusetts.

Where We Go Now

In the wake of the election, the battlefront now shifts to citizen and state resistance. The states are the new firewall. Fourteen states have passed legislation, ballot initiatives, or constitutional amendments blocking the individual mandates. A growing number of governors say they will not participate in setting up exchanges—the bureaucracies that will redesign health insurance and deliver hundreds of billions of dollars in ObamaCare subsidies. Many states also have said they will not expand Medicaid to higher levels, rightly worried that the federal government will lock them into the expansion and then yank back the 100 percent federal funding match.

Citizens also will resist. With the penalty for not buying insurance starting at $95 the first year, why would someone opt to pay thousands of dollars for health insurance when they know they will be able to buy it when they need it anyway?

And companies already are restructuring their workforces to cut jobs and employee hours to avoid thousands of dollars in ObamaCare fines from the employer mandate, fines many say could completely wipe out profit margins.

Strong Resistance Likely

ObamaCare is exponentially more difficult to repeal now, but that doesn’t mean the American people will be any more accepting. It will become increasingly clear that our nation simply can’t afford this massive entitlement at a time that we are facing trillion-dollar-a-year budget deficits as far as the eye can see.

States, individuals, and companies are going to find new ways to rebel against a law that is simply wrong for America.

The nearly 35 lawsuits against the law will continue to make their way through the courts.

The House will hold hearings about the impact of the law in stifling job creation; the crushing burden of $569 billion in new taxes; the costly and burdensome mandates on businesses, individuals, and the states; and the rising costs that add to our shocking national debt.

Those of us in the policy community will continue to make the connection between the law and its consequences as we advance ideas for positive solutions that are right for America.

ObamaCare will fail, but the task of repeal has become much, much more complex and the path forward to right our health sector and economy has become much more difficult. But we will never, never give up in this crucial fight for freedom.

Grace-Marie Turner ([email protected]) is president of the Galen Institute.