The Senate is currently considering a new measure that would allow states to opt out of ObamaCare three years earlier than originally planned. It’s attracted support from an unlikely source: President Obama.
Why would the president endorse an effort that would seemingly undermine his signature law? Because the provision would actually hasten the country’s progress toward the president’s ultimate goal: a single-payer health care system.
The Senate bill would allow states to set up health care systems of their own choosing–so long as they met ObamaCare’s goals for coverage and affordability. States would have to prove that they could cover as many as the federal law would without reducing benefits, increasing the deficit, or raising the price of plans.
The president has championed the bill as a means of giving states flexibility to address their unique health care problems. But by requiring states to comply with all of the federal health care law’s goals, the proposed waiver provision will simply saddle state governments with the responsibility of doing the administration’s dirty work.
“That waiver doesn’t really address the structural flaw we all are facing now,” said Texas Gov. Rick Perry. He’s attempted to flout ObamaCare’s order that his state expand Medicaid–the joint federal-state insurance program for the poor–as a means of extending insurance coverage to more of its residents. But the administration has signaled that it won’t grant waivers to states–cash-strapped as they may be–if they’re planning to limit Medicaid eligibility.
Indeed, as House Energy and Commerce Chairman Fred Upton, R-Mich., explains, “It is highly improbable a state could receive a waiver without a massive expansion of Medicaid.”
So much for “flexibility.”
On the other side of the aisle, many liberal groups see the waiver proposal as an opportunity to launch publicly run and financed insurance plans–or even single-payer systems, where government pays for all aspects of health care–in individual states. The left-leaning organization Consumer Watchdog has promised to push for “ambitious reform plans” in California and elsewhere.
Sen. Patrick Leahy, D-Vt., said that the waiver bill would “give Vermont and other states the choice to go above and beyond what the federal health care law does.” Vermont Gov. Peter Shumlin has already expressed his desire to set up a single-payer system.
Here’s how he’d do so. First, the state would set up an exchange, where residents and businesses could buy insurance. The exchange would attract federal dollars to help with administration and coverage for the poor.
Vermont’s leaders then envision creating a state panel to monitor costs and decide the level of benefits that will be made available to residents once the state moves to a single-payer system.
Finally, they’d launch “Green Mountain Care,” a state insurance plan that would replace all the state exchange plans if Vermont were allowed to opt out of ObamaCare.
Given the path that Vermont’s leaders have outlined, the president’s support for the waivers shouldn’t be surprising. In 2007 then-Sen. Obama told an audience in Iowa that if he were “designing a [health care] system from scratch I would probably set up a single-payer system.”
But the president and his allies in states like Vermont should temper their enthusiasm. Single-payer health care systems simply do not deliver better health care at lower cost. In fact, they deliver neither.
As lawmakers in the Green Mountain State are proving with their plan, single-payer systems control costs by determining what benefits patients receive–in other words, by limiting the supply of care.
Vermont’s northern neighbor–Canada–provides another example of how single-payer systems ration care. In 2010 the average wait from seeing a primary care doctor to getting treatment by a specialist was 18.2 weeks.
Policymakers don’t have the expertise to make medical decisions. As a result, health care will become more politicized and less responsive to patients and doctors.
ObamaCare’s waivers, therefore, do not offer flexibility or choice. They simply offer an excuse to the president’s liberal allies to impose an even more heavy-handed version of government-run health care on their states.