“This month, Jan Brewer of Arizona became the first governor to request what most of the states really need — a waiver from HHS freeing the states from an Obamacare provision known as the maintenance of effort requirements. This is a mandate that forces states to maintain their current Medicaid rolls until 2014 for adults and 2019 for children. If the states trim programs, they end up forfeiting all of Medicaid’s federal matching funds.”

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“In ruling as he did, Judge Vinson wrote that ‘it must be presumed that federal officers will adhere to the law as declared by the court.’ Yet the Obama administration has thus far shown no inclination to do so. But neither has it sought to stay the practical effects of the ruling — perhaps because it thinks that doing so would give credence to the court’s decision.”

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“Back in a November 2009, Utah governor Gary Herbert complained in remarks at the Heritage Foundation that the federal government was ‘freezing out the states’ on health-care reform. How have things gone since then? According to the governor’s remarks (as reported by Jane Norman of CQ HealthBeat) when he returned to the Heritage Foundation last week, ‘Utah officials waited for eight months to find out if the state would be allowed to us e-mail rather than paper to communicate with Medicaid recipients and save $6 million a year.’ Herbert concluded — with bemusement – that ‘they sent us a denial by e-mail.'”

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“Beginning in 2014, the Patient Protection and Affordable Care Act, signed into law in March 2010, is expected to significantly extend health-insurance coverage in New York by increasing Medicaid enrollment and offering federal subsidies for the purchase of private health insurance. However, there is no guarantee that the newly insured will be able to access the health-care system in a timely fashion as new demand for services outstrips physician supply.”

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“Obamacare was passed under the expansive notion that government can run Americans’ health care better than we can ourselves. Bureaucrats in Washington believes they have the power to get things done, but with unmet deadlines passing each month and promises to the American public broken, it seems to be the opposite.”

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“One way to think about all this is to see the ACA as a sham of sorts. Long before the passage of the bill public opinion polls consistently showed over many years that the average voter was willing to pay only $100 or so to insure the uninsured. If you think about it, everything that has come out of the White House and other administration officials is consistent with that finding. ObamaCare, we are being told, is one big free lunch. No one’s premium will be higher. No one’s wage will be lower. Millions of people are supposed to benefit and no one is acknowledged to be the slightest bit worse off because of it.”

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“GOP committee members repeated their warnings that the law will drive doctors away from treating older Americans, ruin people’s ability to keep their current health care, undermine the free enterprise system and place health care in the hands of what one called ‘unelected bureaucracies.’ These were arguments they and GOP House colleagues made last month when the chamber voted to repeal the entire law – a step the Senate has refused to take.”

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“In a hearing of the House Budget Committee today, Paul Ryan asked CBO director Douglas Elmendorf about that claim, saying that some people have argued the new law ‘will create jobs and increase labor force participation. But if I recall from your analysis, it was quite the opposite. Is that not the case?’ Elmendorf answered ‘Yes.'”

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“Sebelius began her remarks by stating that taxpayer funds will not be used to bail out CLASS in the event of insolvency. But a taxpayer bailout is a real possibility for several reasons. First, premiums may be set lower than the actuarially correct amount. This is because there isn’t a useful model for actuaries to determine premiums, especially given the uncertainties of enrollee make-up. Second, within the law’s provisions, if benefits paid out are larger than anticipated, then either premiums will have to increase or benefits will have to be cut. This is a move that would be vigorously opposed by interested parties. Beneficiaries with a vested interest in preserving their CLASS payment will likely lobby vigorously to spread the pain through broad-based tax increases.”

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“If waivers are necessary to keep 733 insurance plans in place now, think of what will be necessary in 2013, when the amount policies must cover in a year will be nearly three times that cost, or in 2014, when full-blown PPACA kicks in and insurers are prohibited from offering a policy without unlimited coverage. The waiver option will be gone: nothing in PPACA gives HHS the authority to waive the statutory ban on annual limits. At the same time, other parts of PPACA will require Americans to have more comprehensive insurance than what they have now. Ineluctably, the result will be to require Americans to purchase insurance packages far more comprehensive and far more costly than what HHS has already determined in 733 cases is too expensive to buy.”

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