Arguing that the future of the Patient Protection and Affordable Care Act (PPACA, known colloquially as “Obamacare”) has resulted in uncertainty for consumers as well as providers of health care, Virginia Governor Bob McDonnell has sent a letter to Health and Human Services Secretary Kathleen Sebelius. In his letter, he asks for clarification of several provisions of the PPACA even while insisting that the law is both unconstitutional and bad public policy.
‘Fundamentally flawed’
In his letter, dated February 7, McDonnell says the law “is fundamentally flawed with unconstitutional and inflexible provisions, and should be repealed.” He also predicts that the PPACA will “ultimately be struck down by the U.S. Supreme Court.”
Federal judges in both Virginia and Florida have ruled that the law, in particular the so-called “individual mandate” that penalizes people who do not purchase health insurance, is unconstitutional. In the Florida case, the judge ruled that, in the absence of a clear severability clause, the entire law fails to meet the test of constitutionality.
While the judicial challenges to Obamacare are running their course, McDonnell argues in his letter to Sebelius, “states are faced with considerable uncertainty.” In this atmosphere of uncertainty, state government will still have to make decisions about health benefits exchanges and other aspects of PPACA, decisions that are more difficult because state budgets are in a precarious position right now.
Six issues
McDonnell lists six specific issues that require clarification by the federal government to alleviate the uncertainty and assure that the health-care system will not be disrupted between now and 2013, when the federal law is scheduled to take full effect (in the absence of a Supreme Court ruling that it is unconstitutional or the decision to repeal the law by Congress and the President).
Among the six items McDonnell asks for are “waivers to the costly mandates” of the federal health-care law and permission for states to set their own eligibility rules; waivers of provisions of the law that hinder health savings accounts (or HSAs) that offer free-market solutions to problems in the health-care system; and the commissioning of an objective study that will show “how many people will end up in the exchanges and on Medicaid in every state as a result of the legislation.”
In his closing paragraph, McDonnell states that, if Secretary Sebelius agrees to his suggestions, “governors might be able to provide coverage to our citizens without destroying our budgets or perpetuating and magnifying the most costly aspects of our health care system.”
In addition to sending the letter to Sebelius, McDonnell also provided copies to the entire Virginia congressional delegation and to Indiana Governor Mitch Daniels, who has been widely rumored to be a potential candidate for the Republican presidential nomination in 2012.
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