A phony Obamacare opt-out
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.
| March 1, 2011; 12:46 PM ET
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