BS Alert: Participating in the Exchange
Tuesday, August 30, 2011
BS Alert by Brett Narloch
Issue: Federalism

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North Dakota Insurance Commissioner Adam Hamm is hosting a public input meeting on Wednesday, August 30th to seek “specific directives from the public” about how to manage the new health insurance exchange being set up in North Dakota as a result of the Patient Protection and Affordable Care act (Obamacare) becoming law. He is also asking the public whether or not the state should participate in the exchange or let the federal government run the exchange themselves.

The law asks each state to set up a health insurance exchange, but does not require it. And the State of North Dakota does not stand to benefit whatsoever by participating in the exchange.

A common argument made for the state’s involvement is that the exchange can somehow be managed better by the state than the federal government. That would be true if it were an option. It is not.

Hamm said, “it’s vitally important for the policymakers to know” what the public wants from the exchange and he wants to jump through all of the hoops created by the federal government so North Dakota can qualify for more and bigger federal grants.

The problem is, according to Michael Cannon of the Cato Institute, that the US Department of Health and Human Services will still determine whether or not your exchanges are in compliance. In other words, local control is a mirage.

Furthermore, those who believe that Obamacare may be unconstitutional – which is 101 of the 141 state legislators – would be violating their oath of office to protect and defend the Constitution if they participate in facilitating the implementation of anything that they believe may be unconstitutional.

And, as Cannon points out, by participating in creating the exchanges, states are legitimizing Obamacare and, thus, will make it harder to repeal.

Lastly, the insurance companies that will be given billions of dollars through the exchanges would spend a lot of money to make sure that the law never gets repealed.

North Dakota should wait until more of the rules regulating the exchanges become available, and wait until an administration in Washington, DC is more favorable toward the states and health care freedom. And reject the money. The federal grants used to get the exchanges off the ground won't be around forever. Eventually, the state - if they decide to manage it right now - will have to pick up he costs of administering the exchange. Kansas recently returned $31.5 million.

A majority of the state legislature supports the repeal of Obamacare. If they truly believe that it should repealed… if they truly think that its unconstitutional… if they are serious about their opposition to Obamacare and weren’t simply playing politics… then the answer is easy: keep North Dakota out of the exchanges. Participating in the exchanges is BS.