Another news cycle, another Republican governor decides to expand Medicaid with ObamaCare dollars.…
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Tennessee Opts Into ObamaCare Medicaid Expansion

Another news cycle, another Republican governor decides to expand Medicaid with ObamaCare dollars.

Last Friday, Tennessee Republican Governor Bill Haslam joined Pennsylvania’s Tom Corbett, Indiana’s Mike Pence and others in trying to carve out a middle ground between a straight yes or no on expansion.

Haslam hasn’t committed himself to specifics, saying only that “sometime this fall” his administration will submit an alternative plan to federal regulators.

States like Wisconsin, Indiana, Pennsylvania, Arkansas and Iowa have won various levels of approval to use ObamaCare’s increased Medicaid funding to provide subsidized health insurance plans to some of the poorest members of their populations.

Expanding Medicaid is a tempting offer because the federal government pays…[more]

September 02, 2014 • 07:28 pm

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Texas Enters Fight to Repeal ObamaCare Print
By Ashton Ellis
Wednesday, January 26 2011
If passed, HB 203 would create a legal barrier for implementing ObamaCare, shielding Texas from the law’s spending mandates.

In the opening days of the 2011 legislative session, Texas State Representative Bryan Hughes (R-Mineola) is serving notice that ObamaCare and its mandates most definitely mess with Texas. 

From time to time, Texas’ commitment to limited government turns freedom into a straightjacket.  Because the state tries to cap the amount of damage done by government, its legislature meets only every other year for 140 days. 

Usually, this is the greatest of public goods.  But one of the consequences of such limited lawmaking is to delay legislative responses to the always-working, always-regulating federal government.  Since ObamaCare was passed and implemented in 2010, a year when the Texas legislature was out of session, fiscal conservatives like Bryan Hughes had to wait until this January to defend their state’s sovereignty. 

With his House Bill 203, Hughes is offering fellow Texas legislators a quick way to make up for lost time.  The bill is the Texas version of model legislation designed by the American Legislative Exchange Council, a national organization of state legislators favoring federalism and conservative policy solutions.  If passed, HB 203 would create a legal barrier for implementing ObamaCare, shielding Texas from the law’s spending mandates. 

A fiscal conservative, Hughes brings unique expertise to health care reform.  As a member of the Texas House of Representatives, Hughes has served on the Human Services Committee with jurisdiction over the state’s health care apparatus.  He recently spent the time between sessions as the co-chair of an oversight committee responsible for modernizing Texas’ welfare system. 

According to Hughes, ObamaCare threatens state sovereignty on three levels.  Constitutionally, the bill’s individual mandate to purchase health insurance turns the Commerce Clause into a club.  “This law gives the federal government the ultimate ability to pick winners and losers, with the losers being everyone who is forced to purchase health insurance,” warns Hughes.  

ObamaCare also degrades federalism.  “State governments are laboratories,” says Hughes, “places where different policies can be tried out.  It’s important that states be allowed to learn from the mistakes of others.  If Massachusetts experiments with state-run health care, Texas should be allowed to choose whether or not to follow suit.  About 1,200 people a day move into Texas from other states because this is where the opportunities are.  If you federalize health care, you nationalize failure.” 

Most immediately for policymakers like Hughes, ObamaCare’s mandated enrollment increases will explode Texas’ Medicaid spending.  Hughes notes that Medicaid already consumes 26% of the state’s budget.  Included within that total are payments covering half of all births in Texas and two-thirds of all nursing home care.  A Kaiser Family Foundation study estimated a 45.5% increase in Texas Medicaid enrollment by 2019 if ObamaCare is implemented fully.  The results would be further budget inflexibility with rises in mandatory spending. 

Hughes thinks there is a more cost-effective way to expand health care coverage.  In essence, if the purpose of “comprehensive health care reform” is to increase access to health care at a sustainable level of spending, there are plenty of free market alternatives.  In his view, states like Texas should be allowed to experiment with state and local level health care exchanges, and greater use of technology to reduce costs.  On the federal level, policymakers should replace the current state waiver request process and allow Medicaid enrollees to use health savings accounts directly as a way to incentivize responsible spending. 

If congressional Republicans are to cut spending successfully, they will need partners like Bryan Hughes and others to refuse federal entitlements that mandate spending at state levels.  With HB 203 and a Republican-controlled state legislature, Texas is now the largest state likely to pass an explicit rebuke to ObamaCare.  If it does so, the Lone Star State will regain its reputation as a leader on state sovereignty issues, and take a crucial first step in restoring budget sanity at all levels of government. 

Question of the Week   
Which one of the following individuals is credited with describing the office of Vice President of the United States as “the spare tire on the automobile of government”?
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Quote of the Day   
 
"Too many Republicans are running on the promise that they will 'check' the president in some unspecified way. They are running as people who dislike Obamacare but have no plans to replace or alter it. But there are persuadable voters who worry that they will lose their health coverage if Republicans get their way, and ones who worry that Republicans will settle for Obamacare Lite. By keeping…[more]
 
 
—The Editors, National Review Online
— The Editors, National Review Online
 
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