Yesterday a coalition of conservative groups, including SAB, held a press conference at the state capitol calling on North Dakota leaders to continue their opposition to Obamacare. You would think that sort of opposition would be an easy sell in a Republican state like North Dakota where 64% of citizens favor repealing the law according to recent polling, but powerful political interests such as Blue Cross Blue Shield (which has a more than 90% market share in North Dakota) as well as supposedly pro-business groups like the North Dakota Chamber of Commerce are agitating to see the state implement the exchanges.
Even Republican Senate candidate Rick Berg is having a hard time articulating a position on the exchanges.
Tomorrow state Rep. George Keiser, who has led the charge for state-level exchanges in the legislature since last year’s special session, will convene the interim Health Care Reform Review Committee he chairs but he may be in for a bit of a surprise. I’m told that Insurance Commissioner Adam Hamm will be testifying against state-level implementation of the exchanges which, far from being the competitive insurance markets supporters say they are, would instead be instruments for tight government controls on what sort of insurance we can buy and how much we have to pay for it.
That’s a fairly courageous move for Hamm, who was largely absent from the debate over exchanges during the legislature’s special session last year (better late than never), especially considering that Keiser also chairs the committee which oversees most of the legislation impacting Hamm’s office.
People like Hamm are stuck between a rock and a hard place. On one side are special interests like BCBS and the ND Chamber, but on the other side is the reality that any perceived support for Obamacare is politically toxic in North Dakota. Supporting Obamacare is why Democrats lost two of the state’s federal seats last year, and is why Heidi Heitkamp more than likely won’t be able to keep the state’s other Senate seat blue either.
That’s as it should be. The exchanges are bad policy, and office-holding Republicans in North Dakota who are for them or who can’t muster the gumption to take a position on them one way or another maybe shouldn’t be office-holders any more.