Patrick B. McGuigan
Three critics of the 2010 federal health care law -- deemed “ObamaCare” by its critics -- contend states will have many options to reform health care policy if some or all of controversial legislation is struck down by the U.S. Supreme Court in the next few days.
In a tele-conference with reporters on Wednesday (June 20), Florida Governor Rick Scott, Tarren Bragdon of the Florida Foundation for Government Accountability, and Dr. Roger Stark of the Washington Policy Center said a range of policy responses could be enacted in the states.
Gov. Scott further contended that if the law is upheld his state and others would have time to react before federal mandates take full effect. He said, however, he believes the federal law will be stricken by the justices.
Bragdon observed that 34 states have already created high-risk pools and put in place other reforms, crafting “tested and proven bipartisan solutions.” Bragdon asserts that before passage of the law, a signature achievement of President Barack Obama’s administration, states were already developing policies aimed at addressing pre-existing conditions and health care for the poor, and could return to that approach if the federal law is stricken by the justices.
The national High Court should rule before the end of June.
Gov. Scott said American states can again operate as “laboratories of democracy” – regardless of whether all of the law, or only the individual mandate, is struck down.
Dr. Stark said “ObamaCare” left a major cost driver in American health care unaddressed, namely the impact of legal costs. In response to a question from CapitolBeatOK, Stark estimated, “There are 5 to 10 percent in costs added to the system, not just in court costs but also in terms of defensive medicine.”
He contends that effect solutions at the state level to counter litigation and/or defensive medicine costs have come in states like Texas and California. Bragdon said guaranteed access to insurance pools for high-risk patients are a better method than the federal law’s mandate to cover pre-existing conditions. Themes of guaranteed access and broader consumer choice permeated the tele-conference.
Dr. Stark, a retired heart surgeon, observed, “Physicians as a group are pretty much non-partisan, and are interested in seeing a bipartisan solution” to the health care controversy. He said most physicians will see Medicaid patients, but need fees sufficient to “pay overhead, pay bills” in conjunction with seeing insured patients.
He said that better solutions than “ObamaCare” would include state reciprocity in licensing, licensure, and certification. He continued by asserting health care policy should evolve toward “more work for physician assistants and nurse practitioners.” He touted a range of medical liability and litigation reforms, saying the legal system as it presently operates brings added costs into the medical arena.
Gov. Scott stated the Sunshine State has been a leader in Medicaid reform, seeking fair payment for doctors and hospital reforms that will take effect on July 1, 2013. Scott said Florida is pressing for an emphasis on choice, accountability, competition, and personal responsibility.
Some reporters pressed Scott on how his state might respond if the federal law, including requirements for state-level insurance exchange systems, is upheld. He replied, “If the law is upheld, we’ll comply with the law.” In dialogue with another reporter, he said a mechanism the state has already created to allow broader access to insurance information is not intended as the equivalent of the exchange system envisioned in the federal law.
Scott told a Washington Post reporter, “We’ll have enough time to respond/react to whatever the High Court does” on the federal law.
On the other hand, he told Gene Meyer of Kansas Reporter, Florida’s experience has been positive in working within some flexibility granted by federal authorities in selected counties of the state. As for possible use of block grants of federal money, allowing states to craft policies tailored to specific needs, he reflected, “Obviously, that will be dependent on the outcome of this presidential election. Striking down [the law] will allow states to be 50 laboratories for experimentation.”
The teleconference was sponsored by three organizations. State Policy Network is a “capacity building service organization” working with America’s “free market, state-focused think tank community.” Americans for Tax Reform is a conservative policy organization that advances the Taxpayer Protection Pledge opposing increased taxes on individuals and businesses.