McDonnell to dazed-and-confused federales: You wrote Obamacare, you implement it.
by James A. Bacon
Governor Bob McDonnell is totally justified in his decision to not set up a state-based health benefits exchange as called for by Obamacare, even if it means relinquishing a modicum of control over health care insurance to the federal government.
He laid out his thinking clearly in a press release issued late yesterday:
For months, Virginia has asked the Obama administration to provide clear guidance and comprehensive answers to important questions that would determine major components and financial impacts to the Commonwealth should we decide to run our own exchange. Originally, I asked that we begin the planning process to potentially operate a state-based exchange for Virginia, primarily so we would be in control of this process. However, despite repeated requests for information, we have not had any clear direction or answers from Washington until recent days, and we cannot conclude, as we review those materials, that we would have the control and flexibility needed to efficiently and effectively run our own state exchange.
If Virginians are faced with running a costly, heavily regulated bureaucratic exchange without clear direction from Washington, then it is in the best interest of our taxpayers to let Washington manage an exchange at this time.
Inevitably, McDonnell will be attacked for pursuing a partisan, anti-Obamacare agenda. But he has steered clear of the kind of inflammatory rhetoric that I would engage in, were I in his shoes. Indeed, he has stressed that he is open to changing his mind should the feds reach a point where they can provide clear direction.
Bacon’s bottom line: If the states are not required to set up their own exchanges, why should Virginia go along? Obama and his acolytes rammed a massive piece of legislation through Congress and the implementation has been fraught with more pitfalls and complexities than its architects imagined. Why should governors like McDonnell help bail out Obama, only to set themselves up for partisan criticism should they fail to deliver functioning health care exchanges under impossible circumstances?
One of the rhetorical tropes of Democrats is that Republicans make incompetent administrators, either out of moronic ineptitude or ideological antipathy to government. Well, let the Dems show everyone how bloody smart they are. Guided by the immortal words of then-House Speaker Nancy Pelosi, “We have to pass the bill so that you can find out what is in it, away from the fog of controversy.”
Obama won re-election and, as he reminds Republicans, elections have consequences. One of those consequences is that he, not someone else, has to implement the hash of legislation he enacted in his first term. Let him figure out what’s in the law and how to make it work.
Republicans cannot content themselves, however, with being the party of “no.” There is one big thing they can do to advance the cause of health care reform in Virginia in the context of Obamacare — they can build upon earlier initiatives to create price and quality transparency in the Virginia health care marketplace. That means getting serious about putting actionable information into the hands of consumers — either directly, through the mechanism of the Virginia Health Information Foundation, or indirectly through the insurance companies. Empowering consumers to make cost-quality tradeoffs when seeking health care services will do more to restrain cost increases and boost the quality of medical outcomes than all the bureaucratic edicts emanating from Washington.
