Last week, Senators Scott Brown (R-Mass.) and Ron Wyden (D-Ore.) introduced the “Empower States to Innovate Act” to fine-tune Obamacare. Under the current law, states can apply for waivers to opt out of the mandates (yet still receive the funding) starting in 2017. The catch is they have to devise state-specific programs that offer as many services and cover as many people as the federal plan would have done otherwise. Brown and Wyden’s bill permits states to apply for waivers starting in 2014, so they won’t have to spend three years under the federal regime only to scrap it for their own programs.
Liberals have hailed Brown and Wyden’s proposal as a bipartisan solution to the Washington gridlock over health care. Wrote Ezra Klein:
What Wyden and Brown are offering is the chance for the various sides to prove that they’re right. If the industry players make the system work better, then the states that prize their involvement will prosper. If conservative solutions are more efficient, that will be clear when their beneficiaries save money. If liberal ideas really work better, it’s time we found out. Forget repeal and replace, or even reform and replace. How about compete and succeed?
Conservatives, however, are more skeptical. As our own Reihan Salam has argued, they worry that by requiring states to match Obamacare’s generosity, the bill prevents them from implementing conservative solutions, such as lifting mandates on insurance companies. “It basically says that if a state wants to do so, it can try to provide people the same expensive coverage with the same government price controls but without an individual mandate,” says Michael Cannon, director of Health Policy Studies at the Cato Institute. “And the only way to do that that I can see is with a single-payer plan.”
“What you have to do is undo about 90 percent of what they did in terms of micromanaging health insurance in terms of Medicaid, Medicare, and other programs,” says Ed Haislmaier, a Senior Research Fellow on Health Policy Studies at the Heritage Foundation. “Otherwise, this is just short of raising the bar and giving you an alternative way to meet it.”
Although Cannon believes Brown should drop the proposal and push for full repeal, Tom Miller, a resident scholar at the American Enterprise Institute, empathizes with Brown. “I don’t want to knock Brown and Wyden. They are actually serious people who sometimes look for different ways to do things,” Miller says. For his part, Brown continues to support full repeal and this bill doesn’t diminish his opposition.
Still, Miller concludes: “What’s a good start on a waiver? Let’s call it ‘repeal.’”