No Medicaid In Your State? Thank ALEC!
December 5, 2013

Another day, another document drop over at The Guardian. This time, we get to see their brag sheets about the progress they've made thwarting progress.

Reports from eight of ALEC's "task forces" shed light on just how much influence they really have over state legislators, and how much of the blame they bear for impeding implementation of the ACA.

In their Health and Human Services Task Force document, they boast that based upon their resolution to oppose state exchanges and Medicaid expansion, "just 17 states plan to operate an exchange for plan year 2014, placing the federal government in a position it had not anticipated.

Thanks, ALEC!

They're also proud of their Resolution against Medicaid Expansion, bragging that "just 23 states have plans to move forward with expansion at this time."

Thanks for that, too, ALEC! Every uninsured working poor person has you to thank when they get sick and have no access to health care. I'll bet it makes you all warm and fuzzy to know that corporations like UPS, Altria, Peabody Energy and PhRMA are busily working alongside corrupt lawmakers to see to it that you die, and die quickly.

What are they planning to do to us next?

According to their published agenda, they are considering several new and/or recycled pieces of model legislation. Here's the list:

  • Health Professional Modernization Act
  • Medicaid Block Grant Act
  • Medical Consultation Act
  • Navigator Background Check Act
  • Oral Health Standards Act
  • Patient Access Expansion Act

Those sound nice and friendly, don't they? They're not. They're the same tired conservative ideas wrapped in pretty names.

The Medicaid Block Grant Act is exactly what the right has touted as a Medicaid answer for years: Give us the money, honey, but don't tell us how to use it. Essentially, they want states to have the right to severely limit Medicaid benefits while taking the full monty in federal funds which they can then use for other areas. Like private prisons. Or privatized public education.

Worse yet, there's a provision in there to require federal subsidies to be deposited to Health Savings Accounts so people can pay more for less care. They're also trying to undermine the federal determination of Basic Health Benefits by sneaking high-deductible plans back into the mix under the cover of Medicaid freedoms.

That "Patient Access Expansion Act?" That seems great, doesn't it? More access is better! It opens the door to all sorts of quackery by forcing states to BAR board certifications. If it passed, anyone could be a specialist even if they never studied for one minute in that field!

The Navigator Background Check Act is just a way to make things more difficult for the Navigators, which are mostly employees of nonprofit organizations assisting with ACA enrollments. They want you to think of them as legions of ACORN employees, all out to steal your identity and screw up your health insurance, so they're suggesting a list of hoops to jump through that involve government background checks. Because we all know how effective those are, right? I wonder if USIS is an ALEC member?

The others are ones that seem like non-sequiturs, but they probably carry a payload I'm not seeing, with one exception. The Oral Health Standards Act adds a requirement for public schools to educate children about oral health. Given that the Academy of General Dentistry joined ALEC in 2013 and paid up front for a two-year membership, perhaps this is their perk for jumping into the organization abandoned by so many others.

Out with the new, in with the old!

Despite the fact that the ACA is now nearly 4 years old and also near full implementation, ALEC has a number of approved resolutions and model bills they are reviewing before they "sunset". Among them is a Resolution In Support of the PhRMA Code and Corporate Self-Regulation, which supports the foolish idea that pharmaceutical companies don't need any regulation because they can do it all by themselves. Also buried in that resolution is the claim that interaction between doctors and pharma reps are "professional interactions" that should be considered "designed to benefit patients." That would be those sample gifts intended to induce doctors to prescribe the expensive patented drugs in place of the less pricey generics.

There is the resolution to create "Convenient Care Clinics." I call this the Wal-Mart provision, because it facilitates and encourages you to do a little shopping, stop by the doctor while you're there, then pick up your drugs in their pharmacy. One-stop shopping for the PlayStation 4 and Xanax, all in one!

For dessert, there's some nice tort reform proposals that make it just about impossible to ever sue for damages in the event of medical malpractice. That set of ideals, combined with the ban on board certifications ought to guarantee the United States' low standing on the ladder of medical excellence for years to come.

Don't ignore their nuclear option

The worst of all of ALEC's model legislation is what they call the "Healthcare Freedom Act," which, if passed in a state, would bar insurers from accepting federal subsidies if it would cause the employer mandate to apply. In fact, if insurers did accept federal subsidies they would lose their license to sell health insurance in that state.

Here's what that means. If an employee declines his or her employer insurance because it is unaffordable and purchases insurance on the exchange, and that employee is eligible for federal subsidies, any insurer who accepts those subsidies will have their license to sell insurance revoked.

Why bother with an employer mandate at all under those circumstances? Of course, as far as I'm concerned, the sooner health insurance is decoupled from employment, the better. But what it would mean to real people is that they'd have to front the cost of their health insurance and receive a big refundable tax credit at year end, rather than offset the monthly cost with the federal subsidy.

It doesn't take a brain surgeon to figure out that corporations would love that provision and people would be hurt by it. Badly. It also explains why health insurers dropped ALEC, given that they're also harmed by such a provision.

Health policy is only a fraction of their extreme agenda

I've focused on their health provisions. Now you should go read the latest Guardian article to see what they're doing with the EPA, green energy, and more. If you thought health policy was bad, wait until you see what they're doing to efforts to undermine all greenhouse gas regulation and punish people who dare to self-install their own solar panels.

Because liberty.

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