It is interesting to watch Governor Walker’s thought process when he has to make a decision where either choice will support one of the tenets of his ideology while violating another. His decision to defer to the federal government in creating a health care exchange is such a case in point.
Apparently his desire to avoid any complicity in Obamacare outweighs the state rights side of his brain. In an op-ed piece titled Choice Is Clear: Let Feds Create Exchange, Governor Walker attempts to walk us through the reasoning he decided to not participate.
The federal government will be too restrictive with too many rules and they will be unwilling to be flexible in the creation of the exchanges (unlike every other federal program that the states implement). So he wants to take a pass. But, no wait, the rules are also too vague and too lacking in details and Wisconsin’s costs will be unknown (although the exchange will be funded by fees on health insurance companies). So he wants to take a pass. I would think if the rules are vague and lacking in detail, the state would have the perfect opportunity to be creative and inventive in creating an exchange that perfectly suits the needs of Wisconsin’s unique culture and environment. But he wants to take a pass.
Here is one thing that Governor Walker is taking a pass on. We have a great number of respected health insurers in the state of Wisconsin. We also have a great number of innovative and creative health care providers in the state of Wisconsin. And we have a great number of business leaders who are concerned with the rising costs of providing health care for their employees who want innovative and flexible ways to continue to provide the benefit. And although these groups have been fairly quiet since the Governor’s decision, many of them had been pushing for a state sponsored exchange. And we have a great number of energetic and responsible citizens in the state of Wisconsin. By refusing to establish a uniquely Wisconsin health care exchange, Governor Walker is disenfranchising each of these concerned groups and institutions. He is not giving them a seat at the table in deciding the future of health care in Wisconsin. That goes against the grain of thought and tradition in our state and once again the Governor is selling his fellow Wisconsinites short.
The federal government will be hard pressed to get all of the exchanges they are now committed to create completed on time. And I am sure many of the Republican governors are counting on the burden they are pushing onto the federal government to create multiple exchanges to slow down the implementation of Obamacare. I fear that we will see a one size fits all result, a good solution overall although Wisconsin might still be better served by controlling our own destiny.
If you want to see the Governor’s letter to Secretary Sibelius at the US Dept of Health and Human Services, take a click here! One of his most interesting statements is “In Wisconsin, we have been successful in providing health insurance coverage to over 90 percent of state residents without the creation of an exchange and absent federal regulation”. Well, I call bullsh*t on that. Wisconsin couldn’t provide that level of health care coverage without Badgercare which utilizes a great deal of Medicaid funding and a great deal of co-operation and flexibility on the part of the federal government. But Governor Walker may not remember how that came about since it started under former Governor Thompson (update).
After you get past the ideology and demagoguery involved with Governor Walker’s every move, here’s the reason he won’t institute a Wisconsin centric health care exchange. He simply can’t. Doesn’t know how. Doesn’t have the expertise on his team. Creating an electronic health care exchange will be quite a daunting task of software development, working with insurers, testing, getting federal approval, etc. is probably beyond our state’s abilities right now. And the management to marshal the necessary resources is beyond his skill set. Just look at the fiasco in WEDC and their inability to even track their loan portfolio! And the fact that he has already squandered nearly a year that was available for planning and early development while hoping the courts or Mitt Romney would nullify the law just adds to his failure. So best leave it to the federal government and not expose himself to a sure failure come the deadline in 2014.
On a side note: One of the ironies involved is Governor Walker’s complaint about this being an unfunded federal mandate….a similar plaint he made while Milwaukee County Executive…something he has failed to rectify since becoming governor.