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Goldwater Institute on Health Care Exchanges

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ARIZONA HEALTH CARE EXCHANGE
These are the highlights from the notes I took at the Goldwater Institute Debate on the proposed Arizona Health Exchange on September 5, 2012.  
by Bill Sandry                                                                                                                                                         
 
 Governor Brewer appointed a committee to adviser her on why Arizona should adopt a health care exchange.  All of them were invited to debate in favor of their position.  However, none of them wouldappear to speak for adopting a health care exchange.  The two panelists for the “debate” were Dr. Eric Novak and Michael Cannon.  Both were very knowledgeable and qualified to speak on the subject.  Despite the efforts of Tom Jenny  to play the devils advocate, there is a strong case for Arizona to join other states and opt out of the health care legislated exchange program, especially if we want to preserve our right to self-determination and freedom of choice in a free market.  These are my notes form the “debate” and not a transcript but it covers the more salient points. 
·
 If we accept a federal or state health exchange the Sec. of Health and Human Services (H&HS) can do what ever she wants– including determining how much of program the state will have to pay.  She can change Arizona’s payment obligation at any time without our consent.
·
 We can opt out and develop our own health care program like 5/6 other states have already decided to do w/o the federal government; the law cannot mandate the state of Arizona participate in any health exchange program.
·
 According to a Bloomberg Report the health insurance companies are projected to make an extra $1T over the next 10 years with the adoption of the health exchange programs.
·
 The entire health exchange program was passed without any funding – it is an unfunded program.  No one knows where the federal government got the $30m for Brewer/Arizona to set up an exchange.  An audit has been called for. 
·
 The taxes/penalties can be enforced only if the state sets up its own health care exchange program.
·
 We will lose jobs to the states that do not adopt the Exchange and have no employer or individual tax/penalty.
·
 The IRS said it will honor tax credits but no legislation has been passed enabling them to make such authorization.  However, the IRS act of authorization triggers the insurance company subsidies – Congress has not authorized these taxes/penalties.
·
 There is no “open market” model because government defines and limits the plans available and the Secretary of H&HS can change them any time she wishes w/o congressional oversight or our consent.
·
 Regarding an abortion policy – the Secretary of H&HS can do what ever she wants. 
·
 The law makes a commoditization of us as patients.  It doesn’t commoditize only the services provided, but the patients as well.  The hospitals are becoming the insurance companies. 
·
 The federal “guidelines” of what the state has to comply with are 27 pages and can be changed at any time by the Secretary of H&HS. 
·
 The AZ/Brewer appointed Coalition supporting the Exchange is made up entirely of businesses and chambers that are involved in health care and that will benefit financially from creating the Exchange. 
·
 The problem with Obama Care is that it has the fiscal restraint of the Department of Defense and the accountability of the Department of Education with nothing on the backend to manage this monstrosity.
·
 California just awarded a $360m contract to advise the state on how to set up an Exchange program. 
· In 10 more years, with an Exchange, more money will be flowing through it than the entire state budget and it will be controlled by the Sec. of H&HS and an unelected, unaccountable and inaccessible panel in a department within the state department of Insurance. 
·
 Every time we accept a federal grant we create a new constituency for the federal government. 
·
 An insurance agent with over 30 years in the business stated that all the high deductible policies (over $2,000) will be eliminated because the law prohibits them.  This will especially hurt young people because they will be paying for “essential” benefits they do not need.  All of us will be paying for some service benefits we don’t need; i.e., women for prostate cancer coverage and men for delivery of babies. 
·
 We will lose jobs and it will stunt economic growth because the taxes/penalties in the law discourage companies to grow over 50 employees.  The IRS’s new 16,000 agents will be looking for companies dividing into two companies or subsidiaries to avoid the 50 employee penalty rule.  
 
 The fight over this law and all the bad coming down from it will continue, the States know the coming storm. When more of the law is enacted people are going to start liking it even less, it will end up hurting more people by the jobs it will kill than the people it will save. I would like to thank Bill Sandry for this, He is one of the people in the trenches here in Arizona trying to make a difference. Thank You Bill!
 



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