Dalrymple Slips Obamacare Implementation Into Budget

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There are two aspects of Obamacare that are optional for the states. One is the creation of the health care exchanges, which are the instrument through which the government will control the insurance market. The states can either implement their own exchange (which the federal government must approve), partner with the feds on an exchange or allow the federal government to implement the exchange.

So far, North Dakota’s leaders up to and including Governor Jack Dalrymple have resisted this implementation, for a lot of excellent reasons. But the other part of Obamacare, made optional by the Supreme Court ruling upholding the law, is the expansion of the state’s Medicaid program.

The federal government funds the expansion, for now, but there’s no guarantee that funding would stay in place in the future. Which is why states should be saying no to the expansion. Unfortunately, in his executive budget, Governor Dalrymple says yes.

From HB1012, the Department of Human Services budget (see below), submitted at the behest of the governor:

SECTION 3. APPROPRIATION – AUTHORIZATION – DEPARTMENT OF HUMAN

SERVICES. In addition to the amounts appropriated to the department of human services in section 1 of this Act, there is appropriated any additional federal funds from the Patient Protection and Affordable Care Act [Pub. L. 111-148], as amended by the Health Care and Education Reconciliation Act of 2010 [Pub. L. 111-152], to implement the provisions for the medicaid expansion. All federal funds received for the medicaid expansion are hereby appropriated to the department of human services for the biennium beginning July 1, 2013, and ending June 30, 2015.

There are three good reasons to support removing this implementation from the DHS bill.

First, North Dakotans overwhelmingly oppose Obamacare. Governor Dalrymple has no business trying to implement any part of that controversial law.

Second, North Dakota has a booming economy. There is no need to expand health entitlements in the state.

Third, in addition to North Dakota not needing an expansion of this program, the federal government is broke. While there is a promise in place for the feds to fund this expansion for now, there’s no guarantee that the federal government will continue funding the expansion in the future. Especially given the fiscal shape the federal budget is in. The most likely scenario, should North Dakota implement the expansion, is that the feds will pull their funding and state taxpayers will be stuck paying for this.

Democrats are happy with Dalrymple’s decision. State Senator Tim Mathern, one of the few outspoken proponents of Obamacare in the state, is applauding the decision. “I thank the Governor for recognizing that the families of North Dakota will benefit greatly from Medicaid Expansion,” said Mathern after pulling his own bill authorizing the expansion from consideration. “This expansion is meaningful action on behalf of people not able to pay for insurance and for the healthcare providers who treat these individuals.”

ND Department of Human Services Budget by

Rob Port is the editor of SayAnythingBlog.com. In 2011 he was a finalist for the Watch Dog of the Year from the Sam Adams Alliance and winner of the Americans For Prosperity Award for Online Excellence. In 2013 the Washington Post named SAB one of the nation's top state-based political blogs, and named Rob one of the state's best political reporters. He writes a weekly column for several North Dakota newspapers, and also serves as a policy fellow for the North Dakota Policy Council.

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  • sbark

    so that was the 25% jump in the human services budget you pointed out early this week….

    it was hidden with camo

    he could’ve hidden it better in the Higher ed budget…..would’ve been a minor line item in there………

    “To become the master, the politician pretends to be the servant.”–De Gaulle

  • RCND

    So I guess the legislature will need to line that one out.

    • http://sayanythingblog.com Rob

      My guess is the House will be able to take it out. Question is whether or not the Senate forces it back in.

  • Shadowwalker

    Maybe our smoker tax dollar could pay for this. What happens when the tyrant’s EPA outlaws fracking….no more riches for this state. It is time for our elected leader to lead by cutting the purse strings on these programs and giving the money back to WE THE PEOPLE. To bad that we have so many among us that live at the trough of the public fund. I have said for years that in the end our esteemed governor was nothing more than a RINO!

  • kevindf

    Where does Tim Mathern think all this new healthcare is going to come from?

  • Clarence A. Herz

    He better slip it the f*&k back out.

  • Patrick R. Pfeiffer

    But Rob!!! THIS money is FREE!!!

    • http://sayanythingblog.com Rob

      That’s probably how they think of it. After all, they think shifting education funding from the local level to the state level is “tax relief.”

      • Patrick R. Pfeiffer

        Yeah! It comes from that same magic free-money vortex the Trillion-dollar coin is going to come from. After all, we’re just borrowing from ourselves right? Ha ha the time will never come when the laws of economics assert themselves and the house of cards comes crashing down.
        Uhhh….

        • camsaure

          Heh, And here I thought it was coming from unicorns all this time. How come the progressive/liberal damocrats are always applauding everything Dullrumple does and the Conservatives are chagrined?

  • $8194357

    DC dhimmi from Bismark.

  • schreib

    If he continues to push that POS bill and try in implement Odipshitcare, than he deserves to loose his job. NO no NO and hec no. We don’t want exchanges that we will be left holding the bag to pay for it yet have absolutely no say in how it is run. Impeach Obama–America’s first communist president.

  • waterjoe

    Of the three reasons Rob gives, only one has any traction.

    The mere fact that the expansion was thown into the final legislation and labeled “Obama care” is irrelevant. There are lots of things that were thrown into the final bill, some of them good, like funding for abstinence-only education. Trying to taint everything with “Obamacare” is pointless. Judge the expansion option for what it is, not where it came from.

    As I’ve posted before, the fact that the state’s economy is doing well overall is not relevant to the question of expanding medicaid. Even if the economy is doing great overall, some individuals might still be unable to afford health coverage. Maybe there shouldn’t be, but if there isn’t then those people would not be eligible.

    That leaves only the last reason given — whether the feds will actually have the money to pay for it or whether the state will be left holding the bag. That is a legitimate concern.

    • http://sayanythingblog.com Rob

      “As I’ve posted before, the fact that the state’s economy is doing well overall is not relevant to the question of expanding medicaid. Even if the economy is doing great overall, some individuals might still be unable to afford health coverage. Maybe there shouldn’t be, but if there isn’t then those people would not be eligible.”

      Maybe you should think about everything you just wrote there.

      • waterjoe

        It still makes sense to me. Just because the state is doing well does not mean that there are poor people. Putting aside whether Medicaid is a good thing – I am not prepared to discuss that at this time – someone who is poor should not be denied assistance just because others in the state are doing well. Eligibility for medical assistance is determined by an individual’s needs, not an individual’s needs in relation to the overall prosperity of the state.

        According to you logic, a person living at 130% of the federal poverty level in North Dakota should be less eligible than a person living at 130% of the federal poverty level in Mississippi.

        • waterjoe

          Correction: Just because the state is doing well does not mean that there are *no* poor people.

        • http://sayanythingblog.com Rob

          Just because the state is doing well does not mean that there are poor people.

          Well, yeah. There’s always going to be poor people. If we set utopia as our goal, we’re going to go broke. You talk often of our fallen world. You ought to know that perfection is impossible.

          What I don’t understand is that, according to people like you, social spending should go up when things are bad and go up when things are good.

          Do you not see the problem?

          This is unnecessary policy. Period.

        • whowon

          Joe, I hope you know we OTHER programs beyond Medicare. CHIPS is one. Yep, people have to sign up!

        • whowon
    • http://sayanythingblog.com Rob

      “That leaves only the last reason given — whether the feds will actually have the money to pay for it or whether the state will be left holding the bag. That is a legitimate concern.”

      It is inevitable.

  • Lynn Bergman

    Medicare and Social Security are earned. Medicaid, as currently administered, encourages inactivity, obesity, and will VERY SOON bankrupt our country economically, morally and ethically.
    Spending a nickle more on Medicaid is foolhardy. And It must be completely reformed to incent courage, work and resulting good health.

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