This afternoon, Sens. Lindsey Graham (R-SC) and John Barrasso (R-WY) are introducing a bill that reinforces the notion that Republicans aren’t very interested in finding alternatives to expanding coverage or lowering health care costs. This particular measure would allow states to “opt out” of the individual mandate, Medicaid expansion, and what Graham refers to as the “business mandate” — a misnomer for a provision that requires large companies to pay a fee if their workers receive government subsidies from the new exchanges.
Here is how Graham describes the legislation on his website:
GRAHAM: If you don’t buy the health care you pay a fine and a lot of people are going to end up getting into government-run systems. But the real problem for South Carolina, is the expansion of Medicaid….So my bill, along with Sen. Barrasso from Wyoming, a physician, is to allow states — if they choose to — to opt out. Remember when Governor-elect Nikki Haley asked President Obama if they could opt out and he said, maybe they could, well, that’s never going to happen. …What I want to do is give every sate the ability to opt out if they choose and take this fight from Washington, down to the state level….before it drives businesses out of the health care business….opting out is a form of repeal and replacing.
I’m not sure why Graham thinks that individuals who forgo the mandate would “end up getting into government-run systems” since the fine is just that — it doesn’t automatically transfer you into Medicaid or some other form of government-sponsored insurance. It simply leaves you uninsured and on the hook for any unanticipated health care spending.
And as for Graham’s overall bill, it’s unnecessarily redundant. Under Section 1332 of the Affordable Care Act, South Carolina can opt out of the individual mandate if it can find an alternative way to expand coverage and lower health care costs. It’s also free to leave the Medicaid program and forgo the millions it receives from the federal government to cover its poorest residents. Of course, Graham’s measure is slightly different — rather than trying to improve the existing individual mandate opt out provision by working with Sens. Wyden and Brown (who are trying to allow states to leave earlier), he wants South Carolina to abandon the mandate without developing any alternative for expanding coverage. Graham doesn’t even pretend to offer any solutions.
In other words, this senator, who receives taxpayer-subsidized health insurance, is openly proposing a measure that would take away coverage from millions of South Carolinians and offer no affordable means for finding insurance. This is the state of GOP health policy in 2011.