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Posted at 12:46 PM ET, 03/ 1/2011

A phony Obamacare opt-out

By Jennifer Rubin

President Obama offered governors a deal on Obamacare yesterday. The Post reports:

President Obama sought to defuse criticism of the new health-care overhaul Monday by saying he is willing to give states an earlier opportunity to opt out of certain key requirements -- but only if they can find their own ways to accomplish the law's goals.

Now there is good reason why the offer "was met with skepticism by many Republican governors who said they need to learn more about the details."

Yuval Levin of the Ethics and Public Policy Center e-mailed me that Obama is offering "essentially nothing." Yuval explains:

He's offering to support legislation that would let states ask for permission to do exactly what Obamacare would require them to do but by different means a little earlier than the law now allows. The law currently allows them to ask for such permission starting in 2017; he now supports legislation that would allow it starting in 2014. But it's not real flexibility because it doesn't allow them to change the ends they pursue, only the means, so they would have to propose something that CBO scores as having the same effect at the same cost (or less) as Obamacare, which means the goals of the law and the peculiarities of CBO scoring still govern.

Yuval contends, "It will be much easier for states to get permission to do more than for them to get permission to do less, " something the White House has emphasized to its allies on the left. Politico reports on a call with "liberal allies" in which the White House went to great pains to assure nervous Obamacare fans that there is nothing to worry about:

Health care advisers Nancy-Ann DeParle and Stephanie Cutter stressed on the off-record call that the rule change would allow states to implement single-payer health-care plans -- as Vermont seeks to -- and true government-run plans, like Connecticut's Sustinet.

The source on the call summarizes the officials' point -- which is not one the Administration has sought to make publically -- as casting the new "flexibility" language as an opportunity to try more progressive, not less expansive, approaches on the state level.

In short, under Obama's scheme, governors could ratchet up the degree of government intrusion, but not lower it. Moreover, Yuval observes that "it will be basically impossible for [governors] to get permission to do something different altogether." With the Department of Health and Human Services running the show and with it having all "the authority to decide who gets permission and for what," you can imagine there won't be too much innovation.

But the concession, albeit phony, is telling. James Capretta, former assistant director of OMB, tells me, "The one thing this does open up is that even the White House admits the new law is flawed and needs to change."

Republicans would be wise to push back with a much broader opt-out proposal. Then we'll see how willing the president is to give governors real flexibility and refashion a very problematic piece of legislation.

By Jennifer Rubin  | March 1, 2011; 12:46 PM ET
Categories:  Obamacare  
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Next: And then there will be three: Newt to announce this week


This is soooo easy to fix, but the goal isn't to fix it.

This hasn't worked in countries smaller than us, it won't work here.

If we really wanted to, we could knock down the price of oil and those countries that rely on oil income to fund this would have to face reality.

Posted by: gopthestupidparty | March 1, 2011 1:10 PM | Report abuse

I don't see this as phony at all. Obama is basically letting states choose a different implementation approach but not game the legislation by allowing them to not implement reform. He is essentially calling the bluff of those who would manipulate the "opt out" to thwart the coverage goals of health care reform.

Posted by: SteveCanyon | March 1, 2011 1:34 PM | Report abuse

Oh course the states want to thwart Obama. Why else would the voters have given so many state victories to the Republicans in the last election.

obamacare will destroy the healthcare delivery system. Government intervention has a track record of destruction. The value of our houses was destroyed by massive federal intervention in the real estate market. The value of our 401K's were damaged by government intervention as well.

the liberals seem to think that their intentions are all that matters. that is arrant nonsense. The results are what matter and every time Uncle gets involved the tax payers get screwed.

the best way to deal with Obamacare is to repeal it. It is an affront to common sense.

Posted by: skipsailing28 | March 1, 2011 2:14 PM | Report abuse

Alexander Hamilton once said "A power over a man's subsistence amounts to a power over his will".

That is exactly what ObamaCare is about. It will not reduce costs. It will not increase personal options. It will simply funnel every man in the direction the state wants. That is why it is so disgusting.

Posted by: RickCaird | March 1, 2011 2:51 PM | Report abuse

I wonder if right wingers know that emergency health care -- the kind folks are stuck with when the don't have health care coverage -- is by far the most expensive health care there is. Are right wingers bright enough to figure that out? Just wondering.

Posted by: J_B_A | March 2, 2011 9:56 AM | Report abuse

I disagree Jennifer.

The opt out provision allows any state to opt out of the ACA if they can provide the same level of health care to the same number of people.

If conservatives think they can do that with less government intervention, god bless 'em and I hope they try it, as real policy innovation is an area that Conservatives (ironically) used to be great at. BUT the key point is that elected Republicans don't care about delivering real health care to all Americans, and giving Republican governors the option to do better than ACA calls their bluff.

Posted by: ChicagoIndependant | March 2, 2011 1:24 PM | Report abuse

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