Megan McArdle describes herself as a “squishy Libertarian”. She’s also a popular blogger for Newsweek and the Daily Beast, and former senior editor at the Atlantic Monthly. McArdle is in Missoula to participate in this week’s Mansfield conference on the future of health care in America. In this feature interview, McArdle talks with News Director Sally Mauk about health care, gun control – and the latest kitchen gadgets. McArdle just did a feature story on the International Housewares show…
The mandate provision of the Patient Protection and Affordable Care Act or “Obamacare” goes into full effect next year, requiring uninsured individuals to purchase health insurance or pay a penalty. Businesses with 50 or more employees must also provide health insurance for their workers, or be penalized. The National Federation of Independent Business opposed the Act and remains one of its harshest critics. Their senior health care adviser, Robert Graboyes (“Gray-boys”), will be in Montana next week, to talk with business owners about the Act’s impact. In this feature interview, News Director Sally Mauk talks with Graboyes about his objections to Obamacare – and his predictions…
Democratic incumbent Senator Jon Tester is locked in a too-close-to-call race with Republican Congressman Denny Rehberg. One of the main themes of Rehberg’s criticism of Tester is that he is a rubber stamp for President Obama, voting with the president 95 percent of the time. In this feature interview with News Director Sally Mauk, Tester disputes that statistic – but says he understands why his opponent wants to make it a big deal…
Either Republican Congressman Denny Rehberg or Democratic Senator Jon Tester will be out of a job soon, as Montana voters decide which one they want to be in the U.S. Senate for the next six years. Their high profile race has attracted millions of dollars spent on attack ads and mailers and phone calls that have bombarded voters’ homes for months now.
In tonight’s feature interview, News Director Sally Mauk talks with Congressman Rehberg, about why he’s giving up his House seat to make this run for the Senate…
We’re looking into the last of three legislative referenda appearing on the November ballot. These are measures referred to the voters by the state legislature.
The full first clause of LR 122 says, “an act prohibiting the state or federal government from mandating the purchase of health insurance coverage or imposing penalties for decisions related to the purchase of health insurance coverage.”
I don’t know if this rings any bells, but it should. It’s probably the most controversial element of the Patient Protection and Affordable Care Act, otherwise known as “Obamacare.”
This referendum has run into a little bit of a hitch though.
“It really has no impact whatsoever,” said Helena Democratic State Senator Christine Kaufmann.
LR 122 was drafted before the US Supreme Court issued its ruling on the Affordable Care Act. That June ruling declared the US Constitution does allow the federal government to mandate the purchase of health insurance coverage. And a law passed by the voters of Montana cannot overrule that.
So in some ways, LR-122 would effectively be a statement from the people.
Republican Speaker of the Montana House of Representatives Mike Milburn says it’s an important one to make. He says the Federal Government mandating to states is becoming more common.
“States should have certain rights and when we see those being encroached upon, we need to push back,” Milburn said.
Democratic State Senator Christine Kaufmann does support the Affordable Care Act, so she wouldn’t want to make that statement. But she says this kind of gesture is pointless anyway.
“It’s an exercise in futility,” she said. “Why should we spend all this emotional energy saying ‘get out of the way federal government, we can handle this ourselves’ when we’ve never been able to handle healthcare ourselves and it’s going to be a meaningless solution.”
LR 122 would be unconstitutional the moment it passes. But, a lawsuit would need to be filed against this new Montana Law and the law would need to be declared unconstitutional by a judge. That ruling could then be appealed, so on and so forth. These things take time.
Meanwhile, if Mitt Romney wins the Presidential election, he has vowed to do everything he can to repeal ObamaCare. Say Romney wins and gains enough Republican support in the House and Senate, repeal is possible. If that repeal happens before LR 122 is declared unconstitutional, then it would no longer be unconstitutional.
MILBURN: “So, it’s still very applicable and we’re hoping it will pass just to send that message,” Milburn said.
Another indication that the fight over health care reform is far from over.
This story uses excerpts from my Montana PBS special on the ballot measures, “From the People: Montana’s 2012 Ballot Measures”
‘Dismantling Obamacare’ has become a major plank in the campaigns of several republican candidates for statewide office in Montana.
Gubernatorial Candidate Rick Hill firmly opposes the Affordable Care Act.And go to the websites of State Auditor Candidate Derek Skees and Attorney General Candidate Tim Fox—Fighting Obamacare is listed as a top priority. A regular mention of gutting Obamacare seems almost required this election season if you’re a republican candidate.
Well, Executive Director of the Montana Republican Party, Bowen Greenwood says elections are supposed to be about issues.
“We bring those things up in every opportunity because that is the point of an election. When the government has gone wrong, it needs to be changed,” Greenwood said.
And he says the Affordable Care Act is a major issue for voters. A recent poll by Lee Newspapers shows 53 percent of Montanans don’t support the law, while 40 percent do.
Dr. Michael Sparer is the Health Policy and Management Department Chair at the Columbia University school of Public Health. He focuses on the politics of healthcare, ,primarily in the United States.
He says the nation is seeing this kind of focus on the Affordable Care act in states across the country. He says it’s a debate not only about the specifics of the healthcare law, but also more broadly about the wider role of government in the U.S.
“I think there’s no doubt that the healthcare issue and the politics of the affordable Care Act are far more intense and are a far more significant part of this campagin than we typically see,” Sparer said.
So what could state Republican Candidates do to fight this federal law if elected?
Sparer says states do have a series of decisions to make, and he points mainly to two. The first is the reform’s health insurance exchange provision.
“Each state under the affordable care act is encouraged but not required but is encouraged to create what’s known as a health insurance exchange,” Sparer said.
It’s basically a government-facilitated insurance pool to get better prices for the uninsured. If the state decides not to create the health insurance exchange, the federal government will create one for the state and run it.
“Unless Governor Romney becomes President and unless the Affordable Care Act is repealed, the state of Montana is going to have a health insurance. the only question is going to be who’s running it, the state or the federal government,” he said.
Republican majorities in the 2011 Legislature turned down proposals by current state auditor Democrat Monica Lindeen to create a Montana exchange. Montana GOP executive Director Bowen Greenwood says whether or not the exchange is made at the state or federal level, some things remain the same.
“We don’t get a real say in the exchanges,” Greenwood said, “about what kinds of insurance companies are going to be allowed to compete or what kinds of insurance our people are going to have. The law does not allow us to have any real say in the fate of our people and that’s why we oppose it.”
Columbia University’s Michael Sparer says that statement is not true, states would have a significant amount of discretion over the form and substance of their exchange.
“Are these Republican Candidates in an effort to sound as if they are refuting the federal government, are they giving the federal government more control?” I asked Sparer.
“I think clearly one thing they’ll argue, those who say they are not going to set up the exchange, one thing they’ll argue is by refusing to do so will save the state money even though most of the cost of setting up an exchange will be set up by the federal government has said they will bear. But state’s will say hey listen we’re not going to use our state employees, we’re not going to use directly state tax dollars. We’re not going to be involved so we’re going to try to save some money here,” he said.
The other major part of the Affordable Care Act up to state leaders that Sparer mentions is the optional Medicaid expansion provision.
Republican candidates are saying they would not expand Medicaid to cover more uninsured, even though the Federal government would pick up most of the tab. Sparer says there’s no doubt that means a state that does not expand Medicaid will have more people that are uninsured.
Some charge that will put some of the poor out of reach of the individual mandate in place in the Affordable Care Act.
But Sparer says the ACA has some exceptions.
“If you don’t have access to affordable insurance in your community, the mandate doesn’t apply to you. Someone who is uninsured who would be eligible for medicaid but the state chooses not to expand the program. Odds are the mandate won’t apply to them and they will simply remain uninsured,” Sparer said.