In an interview with the Lake George Mirror, as well in interviews with other newspapers and in an op-ed piece published by the Watertown Daily Times in November, Congressional candidate Elise Stefanik stated that she favors the repeal of the Affordable Care Act.
She added that she would replace it with, among other things, measures that allow people to purchase health insurance from out of state insurers, purportedly on the grounds that the costs of health care would thereby drop. But anyone familiar with the Affordable Care Act knows that it does permit people to purchase health insurance across state lines.
Sections 1312, 1331 and 1333 of the ACA allows states to form compacts through which insurers are allowed to sell policies in any state that is party to the compact. Those provisions were drafted to permit the less populous states to create larger, more sustainable risk pools, especially among low income groups.
No doubt Ms. Stefanik is aware of those provisions, and perhaps dismisses them because the insurance plans must still protect the consumer and meet the ACA’s definitions of adequate coverage.
I suspect that what Ms. Stefanik favors are measures similar to those John McCain advocated during his unsuccessful 2008 presidential campaign and which have been proposed by conservatives in many states in the south and the west. While they might allow an unregulated market to flourish, they would also encourage the sale of fraudulent policies, or, at the very least, policies with high deductibles and minimal coverage.
Many of those state proposals are based on model legislation drafted by the right wing American Legislative Exchange Council. Rather than a more market-oriented approach to the problem of the uninsured, the proposals are an attempt to reverse the progress made by the Affordable Care Act to cover the uninsured.
The model legislation includes the following provision: “Each Member State… may suspend by legislation the operation of all federal laws, rules, regulations, and orders regarding Health Care that are inconsistent with the laws and regulations adopted by the member state pursuant to this compact.”
States’ efforts to exempt themselves from federal laws date back to John C. Calhoun and his theory of federalism as a mere compact, justifying a state’s nullification of the nation’s laws and secession from the union. We know where that ended: in civil war.
Every policy is based upon an idea, and a bad policy is usually based on a bad idea. It looks to me as though Ms. Stefanik’s prescription for health care reform is one of those.
Illustration courtesy the National Electrical Contractor Association.