February 28, 2011 Leave a comment
I saw a headline at the Times website today about Obama allowing states more ability to experiment with and opt-out of requirements from the health care law. I figured that in no way did this actually signal any meaningful policy change (or if it did, I’d hear about it from Ezra and Jon Cohn with a much more sophisticated explanation). Anyway, checking in on Kevin Drum today, I see that it’s really all about the caveat to Obama’s statement (which really suggests the headline I saw was overplaying it. Anyway, here’s the explanation from the Times:
The legislation would allow states to opt out earlier from various requirements if they could demonstrate that other methods would allow them to cover as many people, with insurance that is as comprehensive and affordable, as provided by the new law….If states can meet those standards, they can ask to circumvent minimum benefit levels, structural requirements for insurance exchanges and the mandates that most individuals obtain coverage and that employers provide it.
Italics mine. (And Drum’s). That’s one really big “if.” So, if states can do everything the ACA does better and for less money, they can opt out of the law. Not exactly a major threat to the legislation. Drum think’s Obama is just calling the Republican’s bluff, which seems like a reasonable supposition:
Basically, Obama is calling the bluff of Republicans who insist that they can build a healthcare system that’s as extensive and affordable as PPACA using some combination of tea party-approved “free market” principles. He’s telling them to put their money (or, rather, money from the feds) where their mouths are, which will probably demonstrate fairly conclusively that they can’t do it. It’s possible that a state like Oregon might enact a more liberal plan that meets PPACA standards, but I doubt that Alabama or Tennessee can do it just with HSAs and high-deductible health plans.
Still, we’ll see. This is a chance for conservatives to show that they have a better healthcare answer in the real world, not just as talking points at a tea party rally. Obama is betting they’ll fail, and he’s also betting they’ll tear each other apart arguing over details while they do it. Life is easy when all you have to do is yell “Repeal Obamacare!” but it gets a lot harder when you have to produce an actual plan.