One Way Virginia can Ensure Higher Premiums and More Bureaucracy

Published November 13, 2011

Is Bob McDonnell about to become Barack Obama’s favorite governor?

He has become one of the most popular governors in the country by pursuing good-government policies and largely avoiding controversial or divisive issues. But what would make Obama happy would be bad for Virginia.

Obama’s health care law requires each state to create a health insurance exchange. In Massachusetts, the exchange + subsidy + mandate model created the most expensive health insurance premiums in the country and even more bureaucracy and government mandates.

That’s why prominent Republican governors – including Bobby Jindal in Louisiana and Rick Scott in Florida – have rejected Obama’s exchanges and the promised taxpayer funding. Only 14 states have decided to implement exchanges. Most are waiting until the major legal challenges and upcoming election are decided.

As one of the few Republicans moving forward with an exchange, McDonnell has been repeatedly cited by Obama’s supporters as proving that even smart Republican governors think it’s a good idea.

It’s not. The law’s status remains in serious doubt, thanks in part to the efforts of Attorney General Ken Cuccinelli and other Virginia conservatives. The individual mandate is currently pending review by the U.S. Supreme Court over a lawsuit brought by 28 states. The latest polling data indicate only 3 percent of Americans support the law and 80 percent oppose its individual mandate.

Whatever the Supreme Court rules, major changes to Obama’s law are coming in the next Congress – either by Democrats seeking to correct its many flaws or by Republicans seeking to scrap it and replace it with something new.

Threats of the federal government creating an exchange without Virginia’s involvement are hollow – and Washington knows it. There is no funding authorized in the law for federal exchanges; HHS would have to find the money elsewhere and likely would have to appeal to Congress as the cost rises and more states choose not to implement.

And due to a drafting error, one part of the law provides only for subsidies “through an Exchange established by the State under Section 1311.” Thus the law does not authorize access to those subsidies – the chief reason for individuals to find the exchange appealing.

Another error was recently discovered by Professor Richard Burkhauser at Cornell: The exchange subsidy costs were calculated based only on the affordability of coverage for individuals, not families. This is a huge problem. Either several million people won’t be eligible for coverage they were expecting, or the exchanges will cost taxpayers as much as $50 billion more than estimated.

Even those who supported and advocated for the exchange concept in Massachusetts and Utah have turned against the idea now that Washington’s rules and requirements are becoming known. After initial regulations were released, The Heritage Foundation’s Ed Haislmaier wrote, “a state would now have no more real control over an exchange it set up than over one HHS established.”

As Louisiana health secretary Bruce Greenstein explained when his state decided against implementation, “If we were to run it, it’d have the governor’s name on top of the letterhead for every letter to businesses and families announcing the increase in premiums.” In Oregon, they’ve chosen a tax on insurance premiums of up to 5 percent. Is Virginia prepared to do the same?

The oath McDonnell swore to uphold the constitutions of the commonwealth and the United States should give him pause before implementing Obama’s law, which may very well be found to be unconstitutional, or spending one dollar earned by the labor of another toward such an end.

After he leaves office, McDonnell may find he has spent the taxpayers’ money to implement a law that no longer exists. That is money the taxpayers will never get back.

As Calvin Coolidge put it, “I’ve noticed that nothing I’ve never said has hurt me.” McDonnell should realize that an Obama exchange he’s never built won’t hurt him.

Benjamin Domenech is a research fellow at the Heartland Institute and managing editor of Health Care News. Email: [email protected].