• I trust the Obama administration more than I trust Arizona with the new health care exchanges.
    posted by Donna Gratehouse at 24 November, 9:21 AM  0 
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    The Goldwater Institute is urging Arizona and other states that haven’t decided whether to set up state-run private health insurance exchanges under the Affordable Care Act to opt out of it and let the feds set them up. Their reasoning for that seems to be based on their dogmatic belief that government-run enterprises are doomed to failure.

    Early on, some state policymakers were misled into thinking that setting up a state exchange would give them flexibility from federal control. There’s also been discussion of urgent “deadlines” states must meet to “comply” with the federal law.

    Federal bureaucrats, ill equipped to execute a comprehensive takeover of the nation’s health insurance industry, have been hoping governors and legislatures would buy these stories.

    What the feds don’t want states to know is that federal law does not require states to establish exchanges. In fact, there’s no rush to make a decision – states may opt in at any time. If states choose not to set up an exchange, the federal government will have to create and fund one on its own.

    I agree that there’s no rush to make a decision! Take your time, Arizona. I’m cool with that! G.I. dislikes the idea of state-run health care exchanges for much the same reasons they dislike state-run public schools – lack of “flexibility”. Yeah well, look how much damage state “flexibility” has done to the schools and social services in the past few years. The Governor and GOP majority in the legislature gave themselves the flexibility to cut thousands of poor adults off Medicaid. Speaking of which, at this point the Medicaid expansion portion of Obamacare, which would provide coverage to people up to 133% federal poverty level, remains undecided in Arizona. Given the hostility of conservatives toward anything from the government that might help people they consider moochers, I don’t expect them to go along with the expansion, even on the generous terms the Obama administration is offering. So why should we trust them to run the insurance exchanges? I’m in complete agreement with Jon Walker, who writes extensively on health care policy on Fire Dog Lake (a liberal site often intensely critical of Obama) on why it’s better to let the feds establish and run the exchanges:

    Financially this should be far more efficient. Creating one of these exchanges is an incredibly expensive IT investment but adding more people to an existing system should be a rather small cost. It should be much cheaper for the federal government to just build one system and use it in 30 states, rather than make 30 states waste money building 30 different systems.

    On a practical level having governors opposed to Obamacare not involved in running the exchanges should produce better outcomes. I would much rather the exchange I’m using be run by the Obama administration, which is heavily invested in trying to make the law work, than have it run by Republican governors, who are ambivalent about the law’s success.

    Politically it is seems as close to a win-win as you can get in the situation. Republican officials who think the law won’t work get to wash their hands of it, Democrats get to try to prove it can work, and regular people will still have access to an exchange.

    Precisely. A big added bonus is that these federally-run exchanges will be under the Obamacare contraception coverage mandate. Women getting their insurance through them will get birth control with no co-pay and Debbie Lesko and Cathi Herrod won’t be able to do a damn thing about it!


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    Donna Gratehouse

    Post Author: Donna Gratehouse

    Bio: I grew up in Silver Spring, MD, and an adventurous streak led me to join the Navy. I moved to Arizona in 1997 after serving 10 years in the Navy to work in semi-conductor manufacturing. I got involved in national and Arizona politics in 2003. I ran for 2006 State Senate in Ahwatukee and was a Delegate to the 2008 Democratic National Convention. I now live in North Central Phoenix with my boyfriend, Mark, and our three dogs. I've been blogging for Democratic Diva since 2007 about local and national politics with a strong emphasis on women's issues.

    Website: http://www.democraticdiva.com/

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