David Merritt, who formerly ran Newt Gingrich’s Center for Health Care Transformation and currently advises the candidate on health policy issues, argues that Republicans should get going on implementing President Obama’s health reform law — even if they really don’t like it:
On Monday, the Department of Health and Human Services released a final rule governing the exchanges. The rule sets an ambitious timeline for getting the exchanges up and running in every state by January 1, 2014. Between now and then, states can either build their own exchanges and tailor them as much as federal law will allow or decide not to build exchanges at all.
But there’s a catch: If states don’t build their own exchanges, the federal government will do it for them.
If states do not move forward on their own, the federal government will. Because of this fact alone, states should move forward with creating their own exchanges. It’s better for states to exert some control over the structure of their exchanges than to abdicate control to Washington.
Perhaps a federal exchange will lard mandate upon mandate on participating plans, driving costs through the roof. Perhaps it will be so restrictive in its plan eligibility that only a few options will be available. Perhaps HHS will offer a public option.
Unless and until the law is repealed by Congress or overturned by the Supreme Court, all health care stakeholders — including state policymakers — need to prepare for it as though it will be the law of the land forever.
Cato Institute’s Michael Cannon has a different take.