Delaware Liberal

Calling Their Bluff

We’ve been putting up with a lot of GOP whining about the health care reform bill. They keep informing us that they have all these great ideas that we wouldn’t listen to (try not to let your eyes roll out of your head if you were a close follower of the HCR debate). One specific issue that the GOP has honed in on is the most unpopular part of the bill, the individual mandate. As many of you know, the bill actually gives states flexibility to enact their own plans as long as it meets the goals of the Affordable Care Act. that means covering a comparable amount of people with affordable coverage, not the proposed race to the bottom. Obama has called their bluff:

President Obama has endorsed minor tweaks to the Affordable Care Act since its passage — most notably the “1099 problem” — but today’s announcement reflects an openness to a more significant kind of change.

Seeking to appease disgruntled governors, President Obama announced Monday that he supported amending the 2010 health care law to allow states to opt out of its most burdensome requirements three years earlier than currently permitted.

In remarks to the National Governors Association, Mr. Obama said he backed legislation that would enable states to request federal permission to withdraw from the law’s mandates in 2014 rather than in 2017 as long as they could prove that they could find other ways to cover as many people as the original law would and at the same cost. The earlier date is when many of the act’s central provisions take effect, including requirements that most individuals obtain health insurance and that employers of a certain size offer coverage to workers or pay a penalty.

Specifically referencing a proposal from Sens. Ron Wyden (D-Ore.) and Scott Brown (R-Mass.), the president endorsed the kind of flexibility Republicans say they want. “[I]f you can come up with a better system for your state to provide coverage of the same quality and affordability as the Affordable Care Act, you can take that route instead,” Obama said, adding, “If your state can create a plan that covers as many people as affordably and comprehensively as the Affordable Care Act does, without increasing the deficit, you can implement that plan and we’ll work with you to do it.”

I believe what Obama just said is Bring It On. I’d certainly like to get a peak of these great ideas that the Reoublicans have been hiding from us. Also, it would allow states to experiment with a single-payer system too. Steve Benen adds that this will really put a lot of pressure on state governors too:

So, how big a deal is this? It marks a fairly significant departure from the administration’s status quo, but at its root, what we’re seeing is the White House call Republicans’ bluff. The GOP is convinced it can offer comparable coverage at comparable prices using Republican-friendly policies. Today, in effect, the president said, “Be my guest.” Why? Because Obama knows it’ll take more than tort reform and HSAs to make the system work, and he sees a political upside to watching GOP officials scramble to actually craft their own plans, rather than bash his.

This approach has many upsides for Obama. For one, it probably takes a lot of air out of the challenges on the basis of states rights and the individual mandate. States are free to get rid of the mandate as long as they meet the goals of the ACA. Plus, it will show these newbie Republican governors that there’s a difference between opposition and actual governing. It will be interesting to see how many plans turn out to be pretty much the plan we’ve already got.

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