CONSERVATIVES in the Oklahoma Legislature, irritated with President Barack Obama and his far-reaching 2010 health care law, made it a point not to comply with a provision of the law requiring states to create exchanges to help consumers buy insurance. Now what will they do?
Digesting the ramifications of the U.S. Supreme Court's upholding of the Affordable Care Act will take some time. But what can't be debated is that Obamacare remains the law of the land, and formation of health insurance exchanges is one part of that law.
Oklahoma was on its way to creating an exchange early last year and it accepted a federal grant to do so. Gov. Mary Fallin and Republican leaders in the House and Senate — all of them staunch conservatives by any yardstick — had agreed on a proposal. Then some senators protested, citing concerns about federal red tape but mostly making the point that accepting the grant was the same as endorsement of Obamacare.
That's all it took to get Fallin and the others to jump ship. The money was returned and the exchange idea shelved.
The toxicity of this law in Oklahoma was such that lawmakers who last summer headed a committee that explored the state's response to Obamacare were labeled as supporters of the law and drew challengers at the ballot box by far-right Republicans.
A coalition of health care entities and business leaders, including The State Chamber and the Tulsa and Oklahoma City chambers of commerce, pushed early this year for formation of a state exchange. The reason was simple: “This issue is too important to risk the imposition of a federally designed exchange.”
But exchanges remained a nonissue at the Legislature in large part because lawmakers banked on the Supreme Court spiking the law. They figured, why spend time on something so unpopular and politically thorny when the law is soon going to be off the books anyway?
Only it's still on the books, and it will remain there unless Congress repeals it. Republicans plan to work toward that, but succeeding will be a tall order. They will need Mitt Romney to win the White House in November, and for the GOP to win a majority in both houses. Oklahoma can't bank on those things happening, although Fallin and others seem content to do exactly that.
Instead, policymakers need to do what they should have done after rejecting the federal grant — get moving on creating a state-based, state-run exchange. The law stipulates that these exchanges need to be up and running by Jan. 1, 2014. State plans for their exchanges are supposed to be filed with the federal government by year's end. States that don't form their own exchanges will see the government create one for them. We absolutely don't want that as the solution.
The Oklahoma Council of Public Affairs, a conservative think tank strongly opposed to Obamacare, noted after Thursday's high court ruling that state policymakers must act. Among the suggestions offered by OCPA fiscal policy director Jonathan Small: “Lawmakers and the private sector must build state-based firewalls — such as a state-based, almost exclusively private-sector-operated insurance marketplace — to minimize the intrusion of the federal government into the insurance market in Oklahoma.”
It's time to get to work on that, finally.