But there’s another “R”: Resist!

Anticipating repeal, governors have significant opportunities to put sand in the gears of ObamaCare. Two have recently taken exemplary action:

• Nebraska Governor Heineman has told his state’s education establishment (i.e. teachers’ union bosses) that the costs of ObamaCare will hit their budgets, because the state will have to raid education funding to pay the price of ObamaCare.  It’s a great way to fragment the big-government coalition that rammed ObamaCare through, and is desperate to block repeal.
• Minnesota Governor Pawlenty has signed an executive order forbidding his bureaucrats from applying for federal grants to set up a state-based “exchange” which would limit people’s choice of health insurance under ObamaCare.  It’s important not to establish a new politically appointed bureaucracy dedicated to implementing a law that is going to be repealed before January 2014, when the exchanges are supposed to dictate what health insurance people can have.

Every governor should look to resist using these and other tactics.  In California, the pro-single-payer legislature has sent Governor Schwarzenegger a bill to set up an exchange that would likely be the most restrictive in the country.   Signing it would create a terrible legacy, and complicate his successor’s ability to resist ObamaCare.

The law makes perfect sense — being able to receive an insurance claim settlement without having paid into the system drives up costs for those who have insurance. It also creates incentives to go without insurance until something bad happens.

In a nutshell, higher costs for insurance combined with no penalties for lack of insurance results in more uninsured drivers.

Oddly enough, the same government that polices auto insurance fraud will soon be working to encourage people to buy health insurance after they get sick. The new federal health care law forces insurance companies to cover people who sign up only after becoming ill or injured, and even prevents them from charging these folks more. The result will be higher costs and more uninsured residents.

But not every insurance regulator is working up to expectations. The Missouri insurance office, for example, lacks adequate procedures for managing the disbursement of federal grants. The revelations come from the Missouri auditor, Susan Montee. Missouri Watchdog’s Brian R. Hook has more.

Information is the key weapon. Republicans can use congressional hearings to explain what ObamaCare is doing to the economy and the health sector. Their strongest cases would be built around jobs, the cost of health care, and the rising deficit.

If evidence shows that looming mandates on employers are crippling job-creation, they should be repealed. If health costs are rising, as they inevitably will be, Congress needs to hold hearings to investigate the causes and explain why the offending taxes and regulations must be repealed.

Here are six key strategies that a Republican Congress could employ to put on the brakes:

• Defund it. House Republican Leader John Boehner of Ohio has vowed to choke off funding for implementation of the legislation, starting with parts that are especially egregious such as the “army of new IRS agents” needed to police compliance.

While Republicans could target the most damaging provisions of the legislation and tie their defunding measures to appropriations legislation that the president wants and needs to sign, they’d better be ready for battles. When former House Speaker Newt Gingrich lost a stand-down with President Clinton over closing down the government in 1996, it was widely seen as a setback for GOP efforts to scale back big government.

• Dismantle it. To focus committee action and floor votes, Republicans can look for provisions in the law that Democrats are on record as opposing. For example, Senate Budget Committee Chairman Kent Conrad (D., N.D.) has said that the new federal program to fund long-term care—the Community Living Assistance Services and Supports Act, or CLASS Act—is “a Ponzi scheme of the first order, the kind of thing that Bernie Madoff would have been proud of.” Mr. Conrad and five of his Democratic colleagues sent a letter to Senate Majority Leader Harry Reid (D., Nev.) before the legislation passed opposing the program and expressing “grave concerns” about its fiscal sustainability.

Other highly unpopular provisions include the requirement that all businesses must file 1099 forms with the IRS to report any purchases totaling more than $600 in a year. This is designed to raise about $17 billion over 10 years from tax cheats. Rep. Dan Lungren (R., Calif.) was the first to introduce legislation to repeal this gigantic paperwork burden. Many Democrats in vulnerable districts who voted for the health law are also anxious to repeal this provision, which the National Federation of Independent Business says will impact 40 million businesses.

• Delay it. Republicans can also vote to postpone cuts to the popular Medicare Advantage program, postpone mandates requiring that individuals and businesses purchase and provide health insurance, and delay imposition of the $500 billion in taxes required by the law. Mr. Obama wouldn’t likely sign such legislation, but the debate would shine a light on problems that haven’t received nearly enough attention.

• Disapprove regulations. The Congressional Review Act of 1996 (CRA) gives Congress the authority to overturn regulations issued by federal agencies if both houses approve, with a two-thirds majority needed to override a presidential veto. This would be difficult to pull off. But proposing a resolution of disapproval under the CRA gives Republicans a platform to express strong disagreement and bring attention to especially egregious rules.

The current congressional majority wants to gut the CRA, and the House passed a bill that would eliminate the requirement that federal agencies submit their rules to Congress before they can take effect. The Senate has not yet acted, but this measure should be on the Republicans’ watch list for the rest of the year.

• Direct oversight and investigation. Other aspects of ObamaCare are ripe for public hearings. For example, rules dictating how much insurance companies must spend on direct medical benefits are already hugely controversial—even before they have been issued. Businesses are also aghast at the narrow openings they have to protect their current health plans from onerous federal regulation. Republicans could summon many witnesses to testify about the impact of this regulatory straightjacket.

Congress also must keep a careful eye on the evolving cost estimates and deficits. Former Congressional Budget Office Director Douglas Holtz-Eakin estimates that the cost of the subsidies for private insurance could rise to $1.4 trillion —triple the $450 billion assumed by the current CBO. This is because the legislation creates strong incentives for businesses to drop coverage and dump their employees into federally subsidized insurance. Congress has a responsibility to protect taxpayers from what surely will be exploding costs.

Republicans also will want to call Donald Berwick, head of the powerful Centers for Medicare and Medicaid Services, to testify before Congress and detail his regulatory agenda for implementing the health-care law. He escaped that duty earlier this year when the White House avoided his Senate confirmation by giving him a controversial recess appointment.

• Delegate to the states. Congress should encourage states to press forward with their own innovative programs. For example, Gov. Mitch Daniels’s popular and fiscally responsible Healthy Indiana Plan expands coverage to the uninsured using a health savings account model. And the lightly regulated Utah Health Exchange provides a marketplace for individuals and small businesses to purchase affordable, portable health insurance. Both are threatened by ObamaCare. The more that states are marching forward with reform that suits the needs and pocketbooks of their citizens, the easier it will be for Congress to repeal ObamaCare and start over.

Americans intuitively understand that government can’t pay for huge new entitlement programs and the expansion of Medicaid with imagined cuts to Medicare, while still improving Medicare’s long-term solvency. They also know that job creation is flat and that employers’ fear of ever-rising health benefit costs is part of the problem. They need to hear the evidence that their fears are valid.

The real wallop of ObamaCare will come in 2014, when most of the spending begins and businesses and individuals are hit with intrusive and expensive mandates. The main job of Republicans, should they capture Congress, will be to slow down implementation of the law and explain to the American people the damage it will do—and already is doing—to our economy. If the White House changes hands in 2012, they can be ready to start with a clean slate and begin a step-by-step approach to sensible reform.

So now there are two public high-risk pools in the state. Guess which pool is more financially attractive to people looking for insurance–and less attractive to the state’s taxpayers? Carolina Journal reports.

It’s not that the state lacks Wal-Mart stores. There are 11 locations in the state, according to AllStays.com, a website geared for RV living. But according to InForum.com, a state law “says the controlling ownership of most North Dakota pharmacies must be in the hands of registered pharmacists.”

An effort to repeal the law, which would open the door for Wal-Mart, Target and other retailers to set up pharmacies, has been underway. But it has stalled by the refusal of the secretary of state to certify a voter initiative on the matter.

But if you look at a person’s costs over a lifetime, it just  isn’t so. From the Center for Retirement Research, at Boston College (PDF):

Our main finding is that although the current health care costs of healthy retirees are lower than those of the unhealthy, the healthy actually face higher total health care costs over their remaining lifetime. To illustrate, the expected present value of lifetime health care costs for a couple turning 65 in 2009 in which one or both spouses suffer from a chronic disease is $220,000, including insurance premiums2 and the cost of nursing home care, and 5 percent can expect to spend more than $465,000. The comparable numbers for couples free of chronic disease are substantially higher, at $260,000 and $570,000, respectively.

We’re spending more on health care. That in itself isn’t a bad thing–we’re also living longer.

I’ve decided to not renew my coverage when the bill comes in for the 4th quarter. I currently pay $320/mo for a $2500 deductible BCBS plan. I have an HSA and have saved up a fair amount of money in it. Pretty good deal. So why drop it? 

1. I have never even come close to meeting my deductible. Everything I have done since HSAs came in has been paid for from my HSA. In fact, never in my life have I ever incurred more than $2,500 in medical expenses in one year.  The odds are that will not change, even though I am older.
 
2. I expect a pretty substantial increase in my premiums, but it doesn’t really matter. I would make the same decision anyway.
 
3. If I guess wrong and my health does change, I will be able to sign up for the new federal risk pool – but ONLY after I have been uninsured for six months. I might as well get started on that six month qualifying period now while I am still healthy.
 
4. There is no penalty for doing this. The federal risk pool is not allowed to charge me more than standard rates.
 
5. Meanwhile I will be able to save $4,000 a year on insurance premiums, which is no small matter these days that I am semi-retired.
 
6. I will not be able to contribute additional money to my HSA, but my income is low enough now that there is virtually no tax advantage to making an HSA contribution. My main tax issue today is the payroll tax, and the HSA has no effect on that.
 
So, I am joining the ranks of the uninsured. Thank you, Mr. Obama.

I can’t really criticize his plan.  He understands ObamaCare all too well.

Under Obamacare, the U.S. government adds to deficit spending by giving out piles of money to state governments, so they can “better” control “unreasonable” insurance costs. The first piles of money have been distributed lately, which has resulted in a shower of news from across the states, including:

Alabama
Arizona
California
Maine
Montana
Nebraska
New Mexico
North Dakota
Ohio
Oregon
South Dakota
Utah