Ezra Klein: New 'bipartisan' health reform proposal: States go own way

[bigtree]

November 21, 2010

Bipartisan plan would let states preempt federal law, see who succeeds.

The GOP's slogan on health care reform has, until now, been "repeal and replace." But Republicans don't have the votes for either. What they might have the votes for is a reform that one day -- if all goes well -- could lead to replacement. And, believe it or not, liberals might be able to get on board with this strategy, too.

This week, Sens. Ron Wyden, D-Ore., and Scott Brown, R-Mass., introduced the Empowering States to Innovate Act. The bill would let states develop health care reform proposals to preempt the federal government's effort. If a state can come up with a way to comprehensively cover as many people as the federal plan, without adding to the deficit, the state can get the money it would have gotten from Uncle Sam for health care reform but be exempt from the individual mandate, the exchanges, the insurance requirements, the subsidy scheme and pretty much everything else.

Wyden, with the help of Sen. Bernard Sanders, I-Vt., was able to build a version of this exemption into the original health care reform law, but for various reasons, was forced to accept a starting date of 2017 -- three years after the full reform goes into effect. The Wyden-Brown legislation would allow states to propose their alternatives now and start implementing them in 2014, rather than wasting time and money setting up a federal structure that they don't plan to use.

One state that wants to give it a shot is Sanders' Vermont. "As a single-payer advocate," Sanders says, "I believe that you can provide quality health care to every man, woman and child in a more cost-effective way. So I wanted to make sure that states have that option." Vermont Gov.-elect Peter Shumlin, a Democrat, is on the same page: "Vermont needs a single-payer system," he said during his campaign.


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[thunder rising]

1. Fuck 'em. NO. There is a catch to this and we all know it.

[subterranean]

4. What's the catch, if they pass this instead of trying to repeal the PPACA?

If there is a catch, I suppose it would be that some red states might opt out of any reform whatsoever.

[thunder rising]

9. Strawman. They cannot repeal shit unless the Dems help.

[Little Star]

2. k&r

[subterranean]

3. I like this idea.

It would be more chaotic at first, with 50 states setting up 50 different systems, but it could eventually lead to a better system than the PPACA, which nobody is really thrilled with. One thing I don't understand is what would people from a single-payer state do if they needed care while traveling in a private-insurance state? Would they need to buy traveler's insurance?

Anyway, I can't see Obama going for this, and if he does, the Republicans will almost certainly oppose it, as will the insurance industry.

[thunder rising]

10. Ha ha! States rights and all that. The wingers want Row V Wade in that arena and we know better.

pffftttt. I smell a concern troll.

[OHdem10]

5. I will have to think long and hard. Are there not about 31 Republican

Governors. Very Conservative Republican Governors.

The first place they cut is Medicaid.

If you live in a state with a history of Democratic Governors
I might with great reluctamce agree.

Sure a New England State trying Single Payer I might jump in.
I live in Ohio where Kasich has his cutting knives sharpened
and ready to go.

There will be no standards. They want to do the same with
Education--Devolve it to the states. No Standards.

[northoftheborder]

7. Living in Texas would be disastrous under..

any plan such as this....they would not do anything.....they don't care. We already spend less state money than any other on health care, even for children. In fact, under present CHIP, Texas does not spend enough state money to even be able to match what the fed. offers, so we have to turn away fed. money for children's health care every year. Very stingy.

[groundloop]

6. I'd be screwed by this plan - right wingers in Georgia would send us back to stone age

Socialized medicine, we don't want no stinkin' socialized medicine.

[jwirr]

8. There is a great big hole in this idea. Back when the states were

running most social programs there was open discrimination and even when the feds paid for it the states made rules to keep certain people from getting help. Not just health care but in many programs.

Anyone interested in this should read up on the study regarding hunger that was done during the McGovern campaign.

The result of putting this idea back into effect will be more poverty in states that are already doing everything in their power to keep help away from people and when possible migration by the poor to states that have better records. I believe that I mentioned that Iowa paid me to move to Minnesota so they would not have to pay for health care costs for my daughter who is severely disabled due to polluted water in their wells.

This pits one state against another. If a state believes it should help its less fortunate citizens and creates some good programs while other states cut drastically the poor will eventually move to the better state. Greed wins and compassion loses.

[JamesA1102]

11. No trust in Wyden at all.

He sponsored a really bad voucher plan last year.

[ProudToBeBlueInRhody]

12. Whatever

If you are stupid enough to put Rethugs in office to speak for you, you deserve whatever shit pie you are served.

[applegrove]

13. Leave it for 2017. At least americans will be able to see how great

HCR works for a few years first.