Repealing O’BamaCare – Maybe













Graham – Cassidy is the latest attempt to repeal O’BamaCare.  It should be up for a vote in the senate the next week or two.  Investor’s Business Daily calls it surprisingly good.

Alaska Senator Lisa Murkowski (R, AK) who last time around voted to kill the repeal she has been voting for over the last seven years has not yet announced what she intends to do.  While I hope for the best, I expect the worst out of her, given her multiple reasons for breaking her campaign promise last time around.

We have heard from all the usual suspects in the Walker administration in strong opposition to the repeal.  Even the Governor’s Council on Disabilities, now refashioned into an echo chamber for whatever DHHS wants, issued a letter in strong opposition.

So, what is really going on here?  The Walker administration is doing its level best to defend Medicaid expansion, the foolish decision by Governor Walker to add another 60,000 Alaskans to Medicaid.  Fortunately, only 36,000 or so signed up, but still, that funding stream must be defended.

The problem with all this is Medicaid is fiscally unsustainable.  While not specifically rationed yet, reimbursements are around the 50% level except for the Medicaid Expansion people who are currently at around the 90% level (see why Walker wants to retain this?).

What is in Graham – Cassidy?  Some pretty good stuff including the following:

  • Medicaid Expansion, tax credits, cost-sharing reduction subsidies, and basic health care plan money – essentially all O’BamaCare payments – will be bundled together and returned to the states as block grants
  • States will have significant latitude over how those dollars are spent and allocated
  • The grant will be run thru the CHIP and is subject to mandatory appropriation
  • The legislation repeals the individual mandate, the employer mandate, and the medical device tax
  • Protects those with pre-existing conditions
  • Eliminates the inequality of 4 blue states getting 37% of O’BamaCare funds by bringing them into parity by 2026.

If a state wants to set up a single payer health care system.  They can do precisely that.  If a state thinks it needs to take better care of those with pre-existing conditions, it can do that also.  You can find the FAQ here:

Scaremongering about seniors, veterans, and handicappers are all based on the fiction that Medicaid Expansion must be kept intact and fully funded.  Medicaid Expansion by its very nature (90% reimbursement of medical spending) preferentially takes care of the new Medicaid Expansion people over veterans and current people on Medicaid (50% reimbursement).  And it is scheduled to end under current law in 2020.

As of this writing, I have not seen anything about repealing the minimum coverage mandate.  I have seen that it will allow selling of health care insurance across state lines.

The basic question behind this legislation is who do you trust?  O’BamaCare, the IPAB, and an army of bureaucrats from DC that are wholly and completely unaccountable?  Or the State of Alaska and its army of bureaucrats in DHSS, most of whom live among us?

While I don’t particularly trust either, I believe those that we can reach out and touch on a regular basis will be much more responsive to our needs than anyone in DC.  And if the Walker administration and his democrat appointees are not up to the task in hand, perhaps it is time for them to resign from office and clear the way for someone else who actually wants to get the job done.

While not perfect, this is a great step in the right direction and we ought to embrace it.

Alex Gimarc lives in Anchorage since retiring from the military in 1997. His interests include science and technology, environment, energy, economics, military affairs, fishing and disabilities policies. His weekly column “Interesting Items” is a summary of news stories with substantive Alaska-themed topics. He is a small business owner and Information Technology professional.

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