Conservatives Confuse Obamacare Architect

Commentary from Twila Brase, President CCHF

February 13, 2013


Obamacare's architects are getting nervous. Ezekiel ("Zeke") Emanuel, a key architect of Obamacare, claims conservative opposition to exchanges is perplexing. In an article for THE HILL, he says the ACA is the law of the land and both Houses passed it. He says the Supreme Court upheld it. And he claims, the 2012 election confirmed it. That should simply settle the matter. Why aren't conservatives falling in line?

What's really perplexing is Mr. Emanuel's perplexity.

Conservatives aren't followers. They lead -- and they read. Obamacare may be 2,700 pages, but they've been reading it. The ACA does not and cannot require states to set up state exchanges. Like the Medicaid expansion mandate, that would be unconstitutional commandeering of the state by the federal government. That is why the ACA has a fallback plan, a Federal Exchange - but they never funded it because they thought states would just build them. Wrong.

Mr. Emanuel says "conservatives should love insurance exchanges" because they "bring free-market forces to health insurance." Once again, conservatives read the law. The Department of HHS runs the entire show. As Texas Governor Rick Perry wrote, any idea of state control is an "illusion." Conservatives realize the exchange is central to Obamacare, and stopping the exchange stops Obamacare.

Emanuel claims it's illogical for conservatives to oppose exchanges because not setting up a state exchange will lead to a federal exchange. I call this Obama's bluff. The ACA appropriated no money -- zero dollars -- for a Federal exchange, and no money has been forthcoming from Republicans in the U.S. House. 

Why such hostility to the exchanges, Zeke asks. He suggests if states build it, they can write their own rules. Goodness. Mr. Emanuel needs to read the law he helped to write and the multitude of federal exchange regulations that have been issued under it. State exchanges are under federal control.
Twenty-six (26) states have said no to federal control. These Republican governors who refuse to build an exchange will protect their employers from penalties under the employer mandate. They will protect many individuals from penalties under the individual mandate. They will protect their taxpayers from millions of dollars in operating costs every year. Unlike capitulating California, which will be spending almost $300 million each year to operate a state exchange, these 26 states will be free high costs and federal control. 
The world's most powerful word is no. Conservatives refuse to be party to the federal takeover of health care. They refuse to cooperate; they refuse to capitulate; they refuse to lend a helping hand to those who want to strip Americans of their God-given rights to freedom.
According to Zeke, "The real objection seems to be: (1) ObamaCare is bad; (2) exchanges are part of ObamaCare; therefore, (3) exchanges are bad." True. True. And true.
Emanuel spins a fairy tale: "Despite the best efforts of conservative governors, the exchanges will open for enrollment on October 1, 2013, and coverage will begin on January 1, 2014." This claim is almost funny. Twenty-six states have said no, there's no money for a Federal exchange, and knowing this reality, HHS waived their own deadline to begin building one.
Toddlers engage in magical thinking, not intelligent adults. Toddlers believe they can make things happen just by saying so. Mr. Emanuel is much too old and learned for magical thinking.
Emanuel also claims there will be "smooth operations within a few years." A few years? Is this good news? Imagine if Apple rolled out the IPhone and expected us to wait a few years for it to work properly. Who would buy it? Only a bureaucrat would classify "smooth operations within a few years" as an acceptable standard.
Zeke makes a final desperate attempt to convince us to cooperate. He claims, "This is not a government takeover of healthcare. This is not socialism. Conservatives would be wise to get on board." Somewhere along the line, Mr. Emanuel got freedom and government control all mixed up. Conservatives are doing fine. But he would be wise to retake History 101.
In freedom,
Twila Brase RN, PHN
President, CCHF

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