Looking toward to a not-s0-distant future where Rick Perry could occupy the Oval Office, candidate Perry had this to say when speaking last week in South Carolina-
If I'm so fortunate to be elected the president of the United States, on Day One, when I walk into the Oval Office, there will be an executive order on that desk that eliminates as much of ObamaCare that I can have done with an executive order.
What should disturb you about this vision of the future is not so much that a President Perry would try to bring Obamacare to an end as that is to be expected from any GOP contender.What should give you pause is that, in a Perry White House, our 45th president would begin his term by signing an executive order that would be, for all real purposes, a blank page.
Talk about an inauspicious beginning as representative of what I fear we might continue to expect from a President Perry.
Like it or not, there is virtually nothing a president can do by executive order to overturn this legislation passed by the Congress and signed into law by the current President.
While a future Congress could, theoretically, bring the Accountable Care Act to an end, and while the Supreme Court may yet destroy part or all of the law before Perry needs to make good on a promise that he cannot possibly keep, the simple fact is that there is really no impact on the law that might result from such an executive order.
Perry is not the first GOP candidate to attempt to bamboozle his audience with such nonsense. Michele Bachmann has promised to single-handedly take down the law right after she gets gas prices down under $2.00 a gallon. Mitt Romney has also promised to devote his first day in office to giving every state in the nation a waiver designed to release them from the dictates of the ACA.
What would that accomplish?
The waiver provision in the ACA has been often discussed, derided and, ultimately, either completely misunderstood or used by Obama opponents to once again twist the truth.
To qualify for a waiver from the requirements of the ACA, a state, employer or employee must show that compliance with the federal requirement would cause “a significant increase in premiums or a decrease in access to benefits.”
Further, the waivers are only good for the period of time that HHS permits, not to exceed the date of full implementation of the law in 2014.
We all recall the huh-bub that arose when waivers were granted to some large employers- like McDonald’s- and a few unions. The Right went crazy, alleging that once Obama had passed his law, he proceeded to shield his friends from the provisions of the same.
This was simply never the case.
The waiver provisions were put into place in anticipation that it would take some employers longer to adjust their benefit programs to the new law. In the case of a company like McDonalds, which employs thousands of part-timers, immediate adjustment to certain provisions in the law would have been devastating. They simply needed more time to make changes in their plan in order to comply.
This does not mean that all companies required this extra time. Nor did it mean that only companies and states friendly to Obama suddenly required the waivers. In fact, the overwhelming majority of employers did not require any assistance and have moved forward with the changes currently required with minimal, if any, discomfort.
The same goes for a couple of states whose laws were at variance with the federal statute.
Take, for example, Florida – a state whose governor is about as hostile to the Obama agenda as one can imagine yet was still granted a waiver. And then there is Tennessee who achieved a waiver despite handing its 2008 electoral votes to John McCain.
Under Florida’s law, a health insurance company is only required to spend 65%-70% of premium income on actual health care. The ACA requires 80%-85% be spent on actual health care benefits and further states that the new formula take effect in 2011. Insurers failing to meet the requirement would be subject to huge penalties in the way of rebates to their customers.
Were Florida to have to implement this provision in 2011, there was a genuine concern that health insurance companies in the state would flee as they would be unable to make such a radical change in so short a time, leaving them exposed to huge penalties via the rebates.
To allow this would have placed millions of Floridians in danger of becoming uninsured should the insurance companies bail out.
Obviously, this was not the intent of the new law. Equally obvious, this was precisely the type of situation the ACA envisioned when creating the opportunity for temporary waivers.
And if you think this is an example of why it is just awful that the federal government is messing in health care insurance requirements rather than leave it to the states, might I respectfully suggest that the logic requires that you rethink this one.
Health insurance companies who only spend 65% of the premium money they collect on actual health care for their beneficiaries do so to benefit their own bank accounts. Because they use this low amount of receipts to pay for actual care, as health care costs go up, they have to charge you more because they are only spending 65 cents of every dollar you send them to pay for actual care. The rest of your money goes into their pocket to pay for inflated overhead -including the people they employ to try to deny you the coverage you paid for- and, of course, profit.
There is absolutely no argument one can make that this is, somehow, good for consumers.
Similarly, you cannot argue that requiring a private health insurance company to spend 85% of their premium revenues on health care instead of spending it on overhead (typically running around 14% for private insurers compared to Medicare which runs at about 3%) is a bad thing for consumers.
Thus, by 2014, every insurance company is going to have to meet this new requirement. A private insurer will not be able to flee Florida looking for greener pastures as it isn’t going to be any easier for them in any other state.
Until then, it was never Obama’s nor the Congress’ intent to upset the applecart so badly that people lost coverage instead of gain it.
So, exactly what is Romney going to accomplish with his promise to give everyone a waiver where he to take office in January of 2013?
While he can waive the requirements of the ACA for every state in the nation, he would accomplish very little indeed, do nothing to end the law and, one year later, those waivers would expire.
As for Perry, I’d love to hear what he believes he is going to accomplish via his first day, executive order as the details have been conspicuously absent.
I suspect I’ll be waiting a long time for that answer.