ON THURSDAY, the Supreme Court upheld the Patient Protection and Affordable Care Act. Regardless of its constitutionality, there are a number of reasons why a heavy-handed, one-size-fits-all health care law imposed by Washington is not the right answer for Massachusetts, or the nation.
We all want affordable health care for our fellow citizens. Massachusetts’s own health reforms — which I supported as a state senator — proved that we can solve the problem of the uninsured at the state level without raising taxes, cutting care to seniors, or issuing new debt.
Let’s take a step back and remember where Massachusetts stood, prior to passage of the national law:
Insurance companies in Massachusetts were already prohibited from turning away patients with pre-existing conditions. Young people, up to age 25, could already stay on their parents’ health plan. Individuals and businesses had many choices. So did large self-insured institutions such as universities and charities. Religious schools and charities were not suing the government for violating First Amendment rights. We did not raise new taxes on our small businesses or promising growth industries.
All that changed with the federal law, which delivers no substantial additional benefits to Massachusetts — just higher costs, higher taxes, more regulations, fewer choices, and new federal spending of $2.6 trillion.
The state gets higher costs, higher taxes, more regulations, and fewer choices. It is bad for the economy, and it hurts seniors and the middle class.
The law is bad for jobs. It raises 18 new taxes, including the job-killing medical device tax, which affects more than 400 medical device companies in Massachusetts. The tax has caused layoffs and hiring freezes in this key growth industry. Across the nation, small businesses that want to grow their workforce above 50 employees face daunting new regulations and much higher costs under the federal law. This creates a major disincentive to hire. In France, where there is a similar threshold for various regulations, there are almost three times as many businesses that have exactly 49 employees as there are with 50 or 51 workers.
The law also hurts seniors. Senior citizens are bracing for more than half a trillion in Medicare cuts — including to Medicare Advantage plans — that were used to offset the law’s massive increase in federal spending. Any Medicare savings we find should be used to make Medicare more solvent rather than paying for a new entitlement.
Costs are rising faster than ever in many cases. According to data from the Kaiser Family Foundation, family health care premiums have risen from $12,680 in 2008 to $15,073 in 2011, despite the administration’s promises that premiums would go down by $2,500 if the bill was passed. The Congressional Budget Office now projects that the new insurance mandates will soon raise premiums on the individual market by an additional $2,100 per family.
College students from middle-class families, for example, are particularly vulnerable to these cost increases. As a result of the law, many colleges and universities that once offered affordable health care plans to students have seen prices rise so much in two years that they have dropped their health plans altogether. Other schools are raising their premiums as much as 50 percent to comply with the new requirements. So much for the “Affordable” Care Act.
We need to remember that our Founding Fathers, when drafting the Constitution, purposefully empowered state governments, and limited the powers of the federal government. They understood that centralizing too much power in a national capital would grow the distance between the people and their elected officials, reduce accountability, and lead to abuses of power. The health care law violates this principle. Procedural tricks were used to pass the law on a party-line vote in the face of opposition from a majority of Americans. New bureaucrats in Washington, hired by the Department of Health and Human Services, as well as the unelected members of the Independent Payment Advisory Board, now get to start making key health care decisions about our care.
That’s what happens when we try to force heavy-handed Washington solutions on problems that require flexibility and creative approaches undertaken at the state level. The health care law should be repealed. We must preserve the right of states to develop and implement health care solutions that meet the unique needs of local citizens, as we were able to do in Massachusetts.