In a Sept. 14 “Special Message on Health and
Wellness,” Gov. Rick Snyder told a statewide audience, “I urge the Legislature to
enact legislation creating the MI Health Marketplace before this Thanksgiving.”
News reports said little about this “health marketplace,” but in fact it
was big news: The proposed state-level health exchange would administer one of
Obamacare’s key elements — insurance subsidies for individuals earning up to
400 percent of the poverty level. This subsidy is the source of the law’s $1
trillion-plus cost over the next decade.
Even for those opposed to Obamacare, there were rational
arguments why the state should create the exchange. Ostensibly, a
state-established exchange would provide greater state control of health care
policy and bring more predictability to Michigan’s insurance marketplace than
waiting for the federal government to create an exchange for Michigan instead.
But from a broader
policy perspective, this seemingly sensible argument was ultimately imprudent
and wrong — a point seen with compelling clarity by Mackinac Center Senior
Legislative Analyst Jack McHugh. McHugh drove this comprehensive view of the
exchange home through relentless original reporting and by sharing the analyses
of the nation’s savviest free-market health policy experts. The effect has been
powerful: Even as reporters and Lansing insiders seemed to take for granted
that the Legislature would deliver this health exchange as requested, the
legislation has stalled.
Over the past 12 months, McHugh has written more than 30
articles and commentaries for Michigan Capitol Confidential. He also authored
Op-Eds that appeared in the Detroit Free Press and Lansing State Journal,
delivered radio interviews, gave talks to local groups, spread the word through
social media and more. While the public at large heard little about the
proposed exchange until recently, for months Tea Partiers, active voters and
others motivated by economic and liberty concerns were kept informed.
When a bill was finally introduced and hearings began
several weeks after the governor’s address, many legislators quickly heard a
clear message from important constituents: “Not so fast!” Although the state
Senate passed a bill on Nov. 10, indications are that the House is less likely
to do so.
Elected officials have told McHugh that the impact of the
Center’s articles is part of why the House has been reluctant to even consider
the legislation. There were also reports that his commentaries were being
circulated among House members. Exchange supporters have complained that his
work was obstructing their efforts.
Under the federal
Patient Protection and Affordable Care Act, states must set up their own PPACA
“exchange” or the feds will do it for them. Many policymakers, though they are
not sympathetic to PPACA, believe that the least-bad option is to create a
state exchange that takes advantage of whatever small opportunities may exist
to insulate Michigan from at least a few of Obamacare’s many destructive
McHugh repeatedly argued that this excessively narrow
focus obscures the infinitely more vital priority of consigning Obamacare to
the dust heap of history’s big government mistakes. There are good reasons —
McHugh cited 10 of them in one article — to expect that moving too quickly on the creation of
an exchange may push that all-important goal further out of sight.
Nevertheless, McHugh pointed out, given the challenges of
compliance, Gov. Snyder’s desire for an early start is understandable. Among
other things, the Governor has spoken of the huge technology issues involved.
Michigan’s insurers also face huge challenges in adapting their operations to
the new law, and they reasonably desire certainty sooner rather than later.
Michigan is not alone — every policymaker in every state
faces the same challenges. But certainty is one thing they’re not likely to get
soon, given past experience with large state/federal social welfare programs.
State control is most likely another forlorn hope. Here’s how the Wall Street
Journal described the first set of federal exchange regulations released last
July: “The word ‘require’ appears 811 times in the 244-page rule and its 103-page supplement. ‘Must’ shows up 580 times — and this
is merely HHS’s first batch of exchange mandates …”
overwhelmingly unconstitutional nature of Obamacare, its assault on individual
choice, and the fact that quick action may detract from the larger goal of
repeal, prudence suggests the Michigan Legislature model the tortoise, not the
hare. Let the U.S. Supreme Court render its verdict in June and allow voters to
render theirs in November. Holding back, even if doing so risks greater
implementation challenges and costs down the road, is worth it when the
ultimate goal is so important.
Thanks to the work of Jack McHugh and the free-market
health care experts whose work he has drawn upon, much of this background was
known by CapCon readers before legislation was introduced this fall. They had
already learned on Aug. 3 in “Michigan Creeps Closer to Obamacare ‘Exchange’ ”
that a flaw in the drafting of Obamacare potentially involving much more than a
mere “scrivener’s error” could bring down its entire tottering structure.
This article also reported that the lead attorney for one of the lawsuits
against Obamacare had just told lawmakers attending a national organization’s
meeting, “Saying ‘no’ to a state exchange is absolutely critical to the success
of our lawsuit and those pending elsewhere around the country.” The piece
explained that a federal judge who ruled Obamacare unconstitutional had cited
states’ creating exchanges as one reason to stay his own ruling.
In the fall, other CapCon items, interviews, Facebook
postings and speeches followed at a rapid pace. Among the articles were, “Obamacare
‘Mandate’ Could Penalize 70,000 Here,” “NFIB: ‘No Rush’ on Creating Obamacare
Exchange,” “Obamacare ‘Exchange’ Opposite of ‘Free Market, ’ ” “‘Exchange’ an
Obamacare Trojan Horse?” and others.
Where this all lands is anyone’s guess, but on one relevant
point the Mackinac Center is certain: While most of those advancing exchanges
are acting in good conscience, the Center’s independent analysis and
free-market principles have never been put to better use than they are now —
helping Michigan residents cut through the bureaucratic clutter and call on
lawmakers for policies that will protect Michigan’s future health care freedom.