Republican State Legislator Tries To Sell Party On Implementing Health Care Exchanges

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Written By:
Rob Port

Jul 10, 2012
2:47pm

In an address to a NDGOP “Victory Lunch” event, state Rep. George Keiser presented his case implementing the state-level health care exchanges from the Obamacare law. This has become a hot-button issue nationally. A half dozen Republican governors, so far, have announced that they’ll be refusing to implement the exchanges (and the Medicaid expansion the Supreme Court exempted the states from), and no fewer than 73 Republican members of Congress have urged the states to refrain from enshrining the exchanges in state law.

Democrats, joined by insurance giant Blue Cross Blue Shield of North Dakota (which no doubt has an interest in maintaining their defacto monopoly on health insurance in the state), are clamoring to implement the exchanges in North Dakota. They’re joined by a couple of Republican legislators including Keiser and Fargo-area Rep. Jim Kapser.

During his address to the NDGOP event, Keiser said that Obamacare consisted of “80 percent” Republican ideals, and that the health care exchanges were a good idea that would “empower” small businesses and consumers. He also stated that Republicans shouldn’t try to repeal all of Obamacare, claiming that some parts of the law are popular, and also stated that if North Dakota didn’t implement exchanges the federal government might use the state as a “model” for federal health care exchanges.

In other words, Keiser was working to scare political leaders in the room into implementing the exchanges. After his address, another SAB reader who was in the room interviewed Keiser about his positions:

Keiser points to Utah, which implemented health care exchanges prior to Obamacare becoming law, as an example of Republican leadership embracing the idea, but that comparison is problematic. Utah’s Governor Gary Herberg has said, “Obama has come along and spoiled the name ‘exchange’.” That doesn’t exactly sound like an endorsement for the Obamacare exchanges from that state’s leadership.

Keiser also claims that North Dakota has the money to pay for the health care exchange now. This is a key point. The exchanges, which include big health insurance subsidies, will represent a heavy burden for states to carry. While North Dakota may be able to afford it now, will we be able to afford it ten years from now? Assuming Obamacare doesn’t get repealed by the next Congress/President (let’s hope for that), Keiser would have us signing up for a major long-term state spending commitment.

Keiser and other supporters of the exchanges would argue that the state would benefit from running the exchanges because it would allow us to control policy locally. This is a falsehood. The federal government calls the shots on every insurance policy sold in America. The exchanges are just a nifty gimmick for tricking the states into taking up the obligation for paying for the exchanges. “Obamacare does not and cannot mandate that states create exchanges,” wrote the Cato Institute’s Michael Cannon back in April. “Moreover, state-run exchanges do not preserve local control. They will do Washington’s bidding, or else they will be commandeered or swept aside.”

This is an important front in the battle over health care policy in America. Republicans like Keiser would have our state surrendering to policy North Dakotans don’t want.