(Note: The following Guest Opinion was written by Rep. Steven Thayn R-Emmett, who is a candidate for the state Senate in the November general election. Thayn’s article deals with his concern for the issues facing the state in light of the Supreme Court decision approving implementation of Obamacare.)
Gov. Butch Otter and the Legislature are currently wrestling with the issue of Obamacare and its mandated health exchanges and if Medicaid should be expanded or not. I have written a report that addresses these issues. The full report is available.
The Affordable Care Act (ACA) was supposedly written to address the rising cost of medical care, which now consumes 17 percent of the gross domestic product (GDP) and rising rapidly. The ACA is supposed to:
• Reduce the cost of medical insurance
• Increase the number of people insured
• Increase access to care
It is my opinion that the ACA will increase the cost of care, reduce access to care and reduce the number of people able to afford private insurance. If the ACA is going to drive up the cost of medical care, reduce access to care and reduce the number of people who can afford private insurance, all of which will reduce the quality of care to Idahoans, then why would the Legislature and the governor implement this law?
Access to care will be reduced because there is no increase in the supply of medical care. The ACA does not increase the number of doctors, nurses or hospitals to provide care. What the ACA does is increase the number of mandated services and the number of individuals who can access these mandated services. What this will do is clog up the system as explained by John C. Goodman in an Aug. 14, 2012, Wall Street Journal report.
Goodman, in his piece titled “Why the Doctor Can't See You,” says “The demand for health care under Obamacare will increase dramatically. The supply of physicians won't. Get ready for a two-tier system of medical care.”
I believe the cost of private insurance will also increase. The premiums for many insurance policies have already doubled. My son, who attends Idaho State University, saw his premiums go from $500 a semester to $900 a semester, effectively driving up the cost of his college education by $3,200.
The ACA also actively works to increase the number of individuals covered by Medicaid. The problem with Medicaid is that it only pays about 60 percent of the actual cost. This means that for every person on Medicaid, private insurance and the self-insured must pay the other 40 percent. In Idaho, it is estimated that another 100,000 people will be signed up for Medicaid.
Fewer and fewer individuals will be able to afford private insurance under Obamacare, making more and more of us dependent upon government programs.
In my full report, I go into more detail on these issues and make references to the book “Priceless” by John C. Goodman, who is the father of Health Savings Accounts. I give over 30 reasons why the ACA should not be implemented. I also provide suggestions on what Idaho can do to reduce costs and improve access. These ideas include:
• Health Savings Accounts (empower the people)
• An accident only policy with add-ons (remove mandated coverage)
• Changes in the tax code to give individuals the same advantages as businesses
I ask questions such as:
• Where will the $40 million to $280 million of extra cost to the state come from? Will we raise taxes or raid the public school fund?
• How can adding 159 new regulatory boards and agencies reduce medical costs?
• How can the federal government begin a new and costly program when it already borrows 42 cents of every dollar?
• How can the Legislature and the governor agree to the regulations of the ACA when the regulations have not even been written?
Finally, I address a path forward for the Legislature by bringing up constitutional, practical and budgetary concerns. The bottom line is that I see no advantage to surrender state authority to the federal government at this time by establishing a state health exchange or to expand Medicaid. We can always opt in at some future point if it becomes necessary to do so.
I sincerely believe that the ACA is such a disaster that if we can resist its implementation for 2-4 years that it will implode and collapse. Unfortunately, it may do so by destroying the economy with it.
The ACA does not require the implementation of a state exchange. The federal government will establish its own exchange. Practically speaking, the federal government does not have the manpower, the funding or the ability to establish an exchange in Idaho unless it bypasses the Department of Health and Welfare. This it does not want to do because the ACA is designed to sign up thousands of people on Medicaid. This takes cooperation with the state.
The ACA mandated Medicaid expansion; however, Justice John Roberts in his decision ruled that the federal government cannot coerce states into the expansion of Medicaid.
I encourage you to read my full report.