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  • Morning Bell: Deadline for States to Claim Their Role in Obamacare

    Tomorrow is an important day for Obamacare. It’s the deadline for states to declare their intentions about setting up their own health insurance exchanges for residents to purchase insurance under the new regime.

    If a state does not set up an exchange, the federal government will come in and set it up, according to the law. So far, 22 states have said they are not going to set up state exchanges. Only six states have received conditional approval from the Department of Health and Human Services (HHS) to operate their own exchanges.

    Why leave it up to the federal government? Well, to begin with, it’s an extremely costly undertaking. Heritage health care experts Nina Owcharenko and Ed Haislmaier explain:

    [T]here will be no steady flow of federal dollars to the states. The law specifies that starting in 2015, any state implementing a state exchange must develop its own revenue source to fund the exchange’s annual operations. That puts the long-term costs squarely on the states. Moreover, the recent announcement by the Department of Health and Human Services (HHS) that it will levy a 3.5 percent administrative fee on coverage sold through the federally run exchanges indicates there are significant costs if a state agrees to run its own exchange.

    And what would be in it for them? Certainly not increased control over how the exchanges are run. Owcharenko and Haislmaier explain that “regulations promulgated by HHS allow states no meaningful flexibility or advantage by operating their own exchanges, relative to a federal exchange. Those states would simply be acting as vendors to HHS.”

    As Pennsylvania Governor Tom Corbett (R) said when he announced his decision yesterday, “It would be irresponsible to put Pennsylvanians on the hook for an unknown amount of money to operate a system under rules that have not been fully written.”

    Governors also have to decide whether to expand Medicaid to able-bodied, low-income, childless adults in their states. This was something President Obama was counting on:

    Congress presumed in PPACA (Obamacare) that the states would agree to build and run exchanges and could be forced to expand Medicaid. The Supreme Court, however, ruled the Medicaid expansion voluntary, which has made states increasingly concerned over new burdens related to costs, control, and coverage—in both the exchanges and Medicaid.

    After the Supreme Court ruled that the Medicaid expansion would have to be optional, it threw a wrench into the Administration’s plan. Half of the reduction in the number of uninsured promised under Obamacare was based on mandating that states expand Medicaid. But the federal government would not cover the full cost of the expansion, and state budgets simply cannot take it on.

    While governors are supposed to decide on the exchanges by tomorrow, there is no firm deadline for their Medicaid decisions, and the states are still all over the place on that issue.

    We are being reminded every day that Obamacare is still a work in progress, and a lot can still go wrong and likely will. These are the problems you face when you try to overhaul one-sixth of the economy in one piece of legislation. HHS is continuing to write the rules of the law, proving as Nancy Pelosi said that we would not know what was in the law until after it was passed. And many parts of it will not be implemented until 2014. As Owcharenko and Haislmaier put it:

    With more Americans still opposed to the law than supporting it, the innumerable technical challenges to implementation, and large and uncertain future costs, there is a significant risk that the whole law could unravel, or even collapse, before fully taking effect.


    Medicaid Expansion and State Health Exchanges: A Risky Proposition for the States by Nina Owcharenko and Edmund F. Haislmaier

    Quick Hits:

    • Blue Shield of California is seeking a 20 percent increase in health insurance rates for some policyholders, reports the Los Angeles Times.
    • Google Maps are returning to the iPhone following widespread ridicule of Apple’s inferior mapping app.
    • Heritage’s Diane Katz warned before Election Day that a regulatory tsunami was coming. The Associated Press reports that it has arrived.
    • In any budgeting debate, the White House and lawmakers tend to claim savings where none exist. Here are five budget gimmicks to reject.
    • Ready to sound off on Michigan’s right-to-work battle this week? Submit your questions for tomorrow’s Lunch with Heritage hangout.
    Posted in Obamacare [slideshow_deploy]

    28 Responses to Morning Bell: Deadline for States to Claim Their Role in Obamacare

    1. Yoikes says:

      I live in PA. If Governor Corbett implements a state managed exchange, he loses my vote in the next election. Period. I voted for him last time, but not the next time if he goes along with 0care.

      • Fae Danner says:

        He should continue to have your vote because he has allowed the federal government to run the PA health insurance exchange. This is counter to what Obama thought the states would do, which would have resulted in the states assuming unknown costs down the line. Do you realize that parts of this law are not even written yet? The Obama administration and everyone who voted them back in must have some malfunction above their necks!

    2. Dennis Bozung says:

      Obamacare is the definite introduction of the United States economy into a global socialistic world order and "Beast" numbering system. The sin of "counting" people has to do with the "Counter" ignoring the attribute and uniqueness of each human soul by refusing to acknowledge that each individual was Divinely created. The anti-Messiah / anti (Hebrew-Christian) world leader will use a global version of "obamacare" that is integrated with "The World Health Organization" (WHO), a specialized agency of the United Nations to track and control the behavior of all citizens of the world. You will NOT receive healthcare, work or conduct commerce without your UN assigned number. Cannot eat, drink, buy or sell without your assigned personal number code that you will carry on your flesh. (Revelation 13: 15-18).

    3. Mary.......WI says:

      One can only hope Obamacare will fail before fully implemented! What a nightmare! Demise of the baby boomers.

      • Sidney18511 says:

        Yeah..just think about how great it will be to see so many American children and adults dying from lack of health care. I can't wait!!

        • Bobbie says:

          That's real ignorant. What's kept them from dying out in the streets since? Funny you think this trouble is worth it for the country when the minority could simply take the responsibility to their own costs of their own livelihoods, their own equine therapy and seek personal resources in times necessary. When your matters are in your control especially your personal health, you build wisdom in your personal choice uninfluenced by "outside control," hence "government controlled care," making you and your responsibilities to society, independently self reliant. What do you have against that?

        • Tami says:

          Hands down and without a doubt, Obamacare will affect how long we wait. Some will die waiting, others will be denied care b/c of age and die. Its written in the law, there absolutely will be a panel to decide if we get what we need. I'm disgusted with John Roberts by finding it constitutional by declaring it a tax. So…it is what is….don't let Obama tell ya he is NOT RAISING TAXES on the middle class! Its only going to get worse.

    4. howiem9 says:

      Are you sure that Obamacare is still "only" 1/6 of the economy? When it causes the economy to contract, isn't it likely to become a much larger part of the economy?

    5. Dr. Henry Sinopoli says:

      Obamacare is a done deal…Ask your new politican leader, DeMint…If he thought there was a chance to kill it he would have stayed in the Senate to earn a little praise for a career of do-nothing service…Heritage get a life…

      • ChuckL says:

        tThe 18th Amendment was also a "Done Deal".

        I refer you to the 21st amendment.

      • Mary.......WI says:

        Senator DeMint might well be able to do more through Heritage than through the senate as long as Harry Reid is at the helm!!!! More power to DeMint!

    6. the beast will consume the flesh and start grinding bone soon the republic will not be able to stand

    7. PaulE says:

      The states that have told the federal government to run these exchanges are the smart ones. Virtually every facet of ObamaCare is going to cost substantially more than it was originally budgeted for, so why should any state want to take on the added financial burden for yet another bureaucracy that is controlled from Washington. Especially when the states would have virtually no say in how these exchanges will operate or what products and services can be offered.

      ObamaCare was all about creating a centrally managed, federal government controlled healthcare system as a stepping stone to the progressive panacea of universal healthcare. Why should any well-managed state want to commit its limited financial resources to help fund this latest exercise in social engineering from the left?

    8. Blair Franconia, NH says:

      Obama broke it. He bought it.

    9. Wayne Peterkin says:

      Back when Obamacare was being argued, well before passage, I had been asking about costs. Polls indicated people liked the idea of pre-existing condition coverage and no lifetime caps. The problem was that these things have costs, and I was asking what those costs would be. The people selling these "benefits" like snake-oil acted like all of this would be free, and any thinking person knew that was not the case. That insurance premiums would reflect these increased costs. I wanted our government to be honest about this stuff so that the public could make an informed decision. Instead, we got lies and half-truths. We are just now starting to see the result.

      Obamacare was designed and intended to fail. As costs mount and people become more dissatisfied, the government will begin to increase the amount of government control. That's what government's always do. Obamacare was to be only the first step toward the socialized medicine that the left-wing really covets. It has never been about better or cheaper healthcare. It has always been about government control and less freedom for the people.

    10. Joyce says:

      Let Obama eat this. This is so stupid no one knows what is in it and are the Democrates going to run fast when this bill starts closing buisnesses because they were stupid enough and bullied enough to vote for something they know nothing about. Reform medical but not this way set down and make small bills and reform small amounts at a time so we know what is going on. This is going to be very bad and hope the people that voted for this eats it.

    11. Bill Stanley says:

      The "Origination Clause" in the U.S. Constitution (Article I, Section 7) requires that taxes be initiated in the House. The Senate took a House bill dealing with veterans and deleted the title and all text, leaving only the bill's number. ObamaCare was then inserted. The Supreme Court characterized the penalties in ObamaCare as federal taxes, but was not asked and did not address the issue of which body of Congress initiated the taxes. The Pacific Legal Foundation has filed a suit (U.S. District Court for the District of Columbia) challenging ObamaCare on this issue. newsandopinions dot net

      • ChuckL says:

        The tax that Justice Rovberts used as the justificatio for the PPACA is a CAPITATION.

        Article 1, Section 9, prohibits "Capitation".

      • Bobbie says:

        isn't that plagiarism? America needs this repealed and this man cited on corruption and fraud of the American people. This should not have commenced due to democratic noncompliance to their job with diligence (by reading it to make an educated decision) and America wouldn't be here.

    12. Melody says:

      Quit calling it Obamacare… it isn't… it is Obama I don't care TAX….. health care will get worse, and the cost go up, and freedom and privacy is on the verge of being abolished…. Defund, burn, and trash the whole think… This will NOT work, and will not be implemented and shouln't be. Take this demonic undertaking and burn it… burn it all.

    13. ChuckL says:

      These quotations from those who were instrumental in the ratification of the Constitution should be considered to be the most authoritative.

      "The constitution of the United States is to receive a reasonable interpretation of its language, and its powers, keeping in view the objects and purposes, for which those powers were conferred. By a reasonable interpretation, we mean, that in case the words are susceptible of two different senses, the one strict, the other more enlarged, that should be adopted, which is most consonant with the apparent objects and intent of the Constitution." –Joseph Story, Commentaries on the Constitution, 1833

      "I entirely concur in the propriety of resorting to the sense in which the Constitution was accepted and ratified by the nation. In that sense alone it is the legitimate Constitution. And if that is not the guide in expounding it, there may be no security for a consistent and stable, more than for a faithful exercise of its powers. If the meaning of the text be sought in the changeable meaning of the words composing it, it is evident that the shape and attributes of the Government must partake of the changes to which the words and phrases of all living languages are constantly subject. What a metamorphosis would be produced in the code of law if all its ancient phraseology were to be taken in its modern sense. And that the language of our Constitution is already undergoing interpretations unknown to its founder, will I believe appear to all unbiassed Enquirers into the history of its origin and adoption." –James Madison, letter to Henry Lee, 1824

      "Against the insidious wiles of foreign influence, (I conjure you to believe me fellow citizens) the jealousy of a free people ought to be constantly awake; since history and experience prove that foreign influence is one of the most baneful foes of Republican Government." –George Washington, Farewell Address, 1796

      "I am not among those who fear the people. They, and not the rich, are our dependence for continued freedom. And to preserve their independence, we must not let our rulers load us with perpetual debt. We must make our election between economy and liberty, or profusion and servitude." –Thomas Jefferson

      "The multiplication of public offices, increase of expense beyond income, growth and entailment of a public debt, are indications soliciting the employment of the pruning knife." –Thomas Jefferson, letter to Spencer Roane, 1821

      "To take from one, because it is thought his own industry and that of his fathers has acquired too much, in order to spare to others, who, or whose fathers, have not exercised equal industry and skill, is to violate arbitrarily the first principle of association, the guarantee to everyone the free exercise of his industry and the fruits acquired by it." –Thomas Jefferson, letter to Joseph Milligan, 1816”

      "An unlimited power to tax involves, necessarily, a power to destroy; because there is a limit beyond which no institution and no property can bear taxation." –John Marshall, McCullough v. Maryland, 1819

      Part 2, the Founder's reassons.

      We can not affored to keep this unlimited federal government which is now populated by smooth talkers seeking only to enrich tehmselves ate the expense of the poorer population of the country.

      It is fixable. Let's fix it.

    14. Pat Finch says:

      This is all about Governmant control. Period.

    15. Jim says:

      Good luck!! Considering the electorate we seem to have now, it looks to me like our days as a free nation are about over. This Country is now a train wreck almost ready to happen.

    16. miko says:

      Mary…….WI · 8 hours ago

      One can only hope Obamacare will fail before fully implemented! What a nightmare! Demise of the baby boomers.

      Baby boomers wanted this crap. blame your own genration. The generation of control.

      • A Defiant Boomer says:

        Wrong, oh far less than wise one. Boomers, almost down to the very last one of us were the ones standing strongest in opposition to it. You must be one of those twenty-somethings who thought that Obama could do no wrong and worked to help get this monstrosity passed. Boomers are far from a generation of control. The great majority of us love our freedom, the opposite of control. We do like to see things done the right way, which is a very, very minor form of control.

    17. grp1953 says:

      I had the scary thought the other day, that the Obama stink tank wants the states to reject the individual exchanges so that they end up with what they always wanted – "the federal single payer " disguised as the savior because many of the states rejected the "state exchanges" and thought they were being smart. I hope I am not right.

    18. Mary says:

      It is just a terrible move that the Supreme Court approved Obama Care. I was very disappointed when they voted for it and said it is a TAX. Never have understood that. Does this mean we are going to pay taxes on our health care expenses.? We are senior Citizens, and so far our Medicare has been okay, except for some of the Doctors planning on leaving when it is implicated. I can say I do not blame them. None of this is needed. Americans can take care of themselves, unless they become indoctrinated by Liberal Democrats who want to control all of our needs. It is a very sad Country at this time.

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