November 16, folks.
That's the deadline for Missouri to decide whether our state government will set up the "insurance exchange" required by the Affordable Care Act (a.k.a. Obamacare), or whether the feds will swoop in and set it up for us.
It's only one week away, so Daily RFT
called Republican state senator Rob Schaaf
of St. Joseph, who's been deeply involved in this issue, and asked whether state leaders will decide on time.
"Deadline schmedline," he says. "An artificial deadline by the federal government doesn't scare me."
Schaaf is not
a fan of Obamacare -- so much so, in fact, he seems to have moved into a weird spot, ideology-wise: As a member of the GOP, he likes
lower taxes for people, but not when Obamacare lowers them.
is the lawmaker who spearheaded the effort to put Prop E on the ballot.
The idea behind Prop E was this: If a statewide insurance exchange
required by Obamacare must come to pass in Missouri, then it should
only be set up with the explicit blessing of the General Assembly and/or
the citizenry, and not by gubernatorial fiat.
(This measure arose
out of the fear that Governor Jay Nixon's administration was
implementing the health law on the sly; with Prop E, Schaaf and his
colleagues sought to guarantee themselves some say in how it gets done).
Last Tuesday, Missouri voters agreed with Schaaf, and passed
But here's the thing: There's really no "if" anymore about
Obamacare. It's happening
. The Supreme Court upheld the law in June, and any hope of repealing it withered when the president got re-elected.
means the uninsured will have to buy insurance (a.k.a. "the individual
mandate"). It also means they'll be able to do this, in Missouri and in
every state, by going to a statewide "exchange," which will be something
like Expedia or Travelocity but for health plans.
exchange can basically only get legs with legislative approval, thanks
to Prop E. But Obamacare gives lawmakers an out: If any state fails or
refuses to set up an exchange, then the feds will come in and do it
So Daily RFT
asked Schaff on Thursday which
he would prefer. You would think he'd want that power and control, since
he worked so hard to get it. But no.
"Let them do it," Schaaf says of the feds. "They have very strict rules how it would be set up, they have veto power
over whether your exchange is acceptable or not, [thus] limiting the state's ability to
innovate anyway. So if the feds want to do it, then let them do it."
Schaaf believes that things will look quite different depending on who sets it up.
example, under Obamacare, low-income folks can get a tax break for
buying their insurance. In Schaff's reading of the law, though, they
won't get the tax credit if the feds set up a state's exchange.
But wait, we asked him: That's
situation you prefer? You prefer that the feds set up the exchange, so
that if Missourians are forced to buy insurance, then they not
get a subsidy for doing so?
you believe in subsidies, then that would be bad for you," Schaaf says.
"I myself don't believe we need to expand the welfare state."
Professor Timothy S. Jost
, a health-law expert at the Washington and Lee Law School in Virginia, tells Daily RFT
that he's heard of this kind of Republican position on the exchanges, and thinks it makes no sense.
"It always struck me as odd," he says, "because Republicans are usually in favor of tax benefits for people."
says that most people -- the IRS included -- have interpreted the law
to mean that low-income folks will get that tax credit no matter who
sets up a state's exchange.
"The larger point," Jost says, "is
why would a state official want to deny the citizens of Missouri who
can't afford health insurance access to probably billions in tax
benefits so they can get insurance?"
Schaaf has an answer to that question. He tells Daily RFT
that "there are fines that are applicable to employers who have too many people going through the exchange" to get their Obamacare-mandated coverage. "But those fines are only applicable if there's a state-based exchange."
Again, Professor Jost disagrees and maintains that Congress clearly intended the exchanges to run the same way, regardless of who sets them up.
In any case, Schaaf insists that the states need more guidance from the feds on how to run this exchange.
"We have to get more information," he says. "Whether or not we should do it is very complicated we don't
know what all the thousands pages of rules from Health and Human Services are, and what our options
are. Whether or not we do this will take a lot of study."
But by now, it's pretty clear: Somebody's going to have to do it. Doesn't sound like it's going to be Jeff City.