Right On: Republicans return health care choices to the states

Composite image | Photo of U.S. map courtesy of ZStoler via Wikimedia Commons , St. George News

OPINION — Republicans failed to keep their commitment to repeal Obamacare thanks to the late Sen. John McCain who reneged on his promise to join them. As a result, the Trump administration is taking a number of steps to return health care policy choices to the states.

Republican-dominated states like Utah are thrilled. States where Democrats hold power are scrambling to preserve some of Obamacare’s features. The result: health insurance options will increasingly depend on where you live.

Take a look at some of the changes underway.

For starters, the Republican Congress eliminated the highly-unpopular Obamacare mandate to buy health insurance or pay a fine. As part of their scramble to preserve Obamacare at the state level, both Vermont and New Jersey have enacted state penalties. Others may follow.

Next, the federal Health and Human Services Department has issued rules that allow individuals and families to purchase low-cost, less-comprehensive health insurance. Obamacare’s authors included such plans, intending them to allow those between jobs to maintain insurance coverage. The law provides that these policies may extend up to a year.

Obama administration rules limited such plans to three-month durations to force people onto the Obamacare insurance exchanges. HHS has revised the rules, allowing policies to run for the full year allowed by law. Offering these policies is up to the states, all of whom regulate insurance products sold to their residents.

Conservative Idaho and Iowa are first out of the chute in approving these short-term health insurance policies; other conservative states including Utah are watching with interest.

But if you live in California, New York or other liberal bastions, don’t expect to find short-term health insurance. The liberal elites governing your states know what’s best for you. Their residents must carry comprehensive coverage for things like maternity care regardless of gender, age, marital status or whether men have had a vasectomy. Ditto for annual physical exams of uncertain value.

Liberals argue that allowing healthy people to choose lower-cost options will leave the less-healthy with higher insurance premiums. Their solution: force healthy people to buy high-priced insurance they don‘t need or want.

Obamacare’s authors foisted this onto us to disguise its true costs. But in doing so, they levied what amounts to a highly regressive tax on those with lower incomes, betraying what they claim are their liberal principles.

In yet another inconsistency, Obamacare’s authors knew they didn’t dare eliminate the plush health insurance policies unions have negotiated with large employers. Employer-provided health insurance is provided tax-free to employees while most of those using the Obamacare exchanges must use after-tax dollars.

Nonetheless, the low wage and salary increases of the last few years are due in part to employers’ higher health insurance costs mandated by Obamacare. Employers can deduct the cost from their taxable income, but higher costs are higher costs.

If your employer was forced to add coverages that fit your needs, count yourself lucky. If these newly-required coverages don’t help much, sorry about your stagnant income.

Trump’s HHS is moving ahead on a third front.

Large employers can provide health insurance at lower cost than the same coverage available to individuals through Obamacare exchanges. Why? Because employers offer up large numbers of beneficiaries and handle most of the paperwork, allowing insurance companies to avoid having to issue and service thousands of individual policies.

Overcoming this inherent disadvantage, HHS has liberalized rules allowing employer groups, associations and the like to offer lower-cost group health insurance plans similar to those offered by large companies. Employer groups and associations were prevented from offering these plans by the Obama administration that wanted to push as many as possible onto Obamacare insurance exchanges.

In a fourth action, HHS is giving states more leeway in implementing Medicaid work requirements while requiring them to conform to the full intent of existing law. That contrasts with the Obama administration that was happy to look the other way when liberal states used subterfuges to avoid statutory work requirements. We all pay for these dodges: The federal government pays over half of Medicaid costs.

The Trump administration has made it clear that it will do all it can within the limits of the law to dismantle one-size-fits-all Obamacare.

Democrats argue that everyone must have comprehensive coverage, fearing that given the freedom to choose, some folks will make poor choices. They think it’s better to make those decisions inside the Beltway and apply them to everyone.

No surprise that I’m with the Republicans on this one.

Howard Sierer is an opinion columnist for St. George News. The opinions stated in this article are his own and may not be representative of St. George News.

Email: hsierer@stgeorgeutah.com

Twitter: @STGnews

Copyright St. George News, SaintGeorgeUtah.com LLC, 2018, all rights reserved.

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12 Comments

  • AnnieMated September 27, 2018 at 5:01 pm

    There are so many lies and misinformation in this editorial that I’m surprised the editors at St George News allowed it to be printed.

    • Happy Commenter September 27, 2018 at 5:43 pm

      Actually it is a factual article.. but it is also an opinion piece. Unlike special eddy, Howard actually researches the facts before he submits his opinion.

    • Utahguns September 27, 2018 at 5:58 pm

      Then would you care to point out the facts versus lies for us, professor?

      • Happy Commenter September 27, 2018 at 7:02 pm

        Why don’t you have annie point to the lies for you since you are unable to find them yourself..

        • Utahguns September 27, 2018 at 9:12 pm

          Pfffft…
          And you can speak of truths? Go sit in the corner.

          • Happy Commenter September 27, 2018 at 10:06 pm

            Ask annie…She’s the one who says it is full of lies.. I see it for what it is.. you got a problem with that?

      • AnnieMated September 27, 2018 at 9:36 pm

        Yea you know I would but I don’t want to. 🙂

  • bikeandfish September 27, 2018 at 7:01 pm

    I agree on much of the analysis of the ACA.

    But your notion that it’s responsible for stagnant wages is inaccurate. We know average American middle class wages haven’t grown much for 50 years even in periods of significant growth.

  • Red2Blue310 September 27, 2018 at 8:18 pm

    Doesnt matter. Utah is the worst on wages and unaffordable healthcare. High deductibles. You are lucky to have Medicare.

  • tazzman September 27, 2018 at 9:50 pm

    Eh…give each person portability and a tax free MSA. But this chasing around of the Romneycare or Obamacare….Thanks again Mitt, you carpetbagger!

    medical Savings Accounts, tax free and individual portability.

    • bikeandfish September 27, 2018 at 10:23 pm

      But they provide no insurance. Once you’ve had one bill over $50k you understand the limitations of MSAs real fast. They serve a purpose but they are not insurance.

  • Striker4 September 28, 2018 at 3:48 am

    well Sunday is right around the corner. they can repent for the lies then

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