In
2014, Georgia Gov. Nathan Deal signed a bill that bans the state from
participating in significant portions of the Affordable Care Act (ACA). It goes
into effect on July 1 of this year.
Introduced by Rep. Jason Spencer,
the legislation pushes back against the ACA in four ways and will create
serious impediments to the implementation of the federal act in Georgia.
Specifically, the legislation:
1.
Prohibits any state agencies, departments or political subdivisions from using
resources or spending funds to advocate for the expansion of Medicaid. This
provision works hand-in-hand with HB990 to make it more difficult to expand
Medicaid. HB990 requires legislative approval for expansion of the program,
barring the governor from doing it by executive order.2. Prohibits the state of Georgia from running an
insurance exchange.3. Refuses and federal grant money for the purpose of
creating or running a state insurance exchange.4. Ends the University of
Georgia Health Navigator Program. It allows the school to complete the
functions under the current grant but would prohibit it from getting a new one.
Each of these provisions creates
impediments to the implementation and execution of the ACA in Georgia. We’ve
seen the difficulties created by the number of states simply refusing to set up
exchanges. The ACA was predicated on state cooperation. By refusing to help,
passage of the Georgia bill puts the federal government in an almost impossible
position. It never intended to run the healthcare system alone, and ultimately,
it can’t do it without state help. Judge Andrew Napolitano agreed recently,
pointing out that if a number of states were to refuse to participate with the
ACA in a wholesale fashion, that
multi-state action would “gut Obamacare.”A fifth provision that would
have prohibited the Commissioner of Insurance from investigating or enforcing
any alleged violation of federal health insurance requirements mandated by the
ACA was amended out of the final bill. Spencer has already committed to
pursuing that issue as a follow up bill in the 2015 legislative session. If
passed into law, this would put the onus of enforcing federal mandates on the
federal government, and it lacks any agency to take on that role. The feds
expect the state to enforce its mandates. State refusal will create quite the
problem.
Second Step
This action by Georgia is actually
the second step towards an effective nullification of the ACA. More than a
dozen states have already taken the first step with passage of a Health Care
Freedom Act or Amendment in the past four years. These states have already
codified in law or their state constitutions that “no governmental entity shall
coerce, directly or indirectly, any individual to participate in a healthcare
system, nor interfere with an individual’s freedom to directly purchase lawful medical services. ”These laws or
constitutional provisions prohibit those states from supporting the ACA in any
way that addresses the mandate. In order to operate an exchange, state
employees would have to determine eligibility
for ACA’s “premium assistance tax credits.” Those tax credits trigger
penalties against employers (under the employer mandate) and residents (under
the individual mandate). In addition, state employees would have to determine
whether employers’ health benefits are
“affordable.” A negative determination results in fines against the
employer. These are key functions of an exchange. Ergo, if the state passes a
law establishing an exchange, then that law would violate the state’s
constitution or statute by indirectly compelling employers and individual residents
to participate in a health care system. That sort of law seems precisely what the Health Freedom Act/Amendment exists to prevent.
Follow up legislation
Recommended steps for states in the
2015 legislative session:
1. For states that have passed Health
Freedom Act v.1
- legislation should be
introduced and passed to ensure that state officials are expressly prohibited
from taking actions supporting the ACA in any way that helps effectuate the
mandate.
2. For all other states
- the Georgia legislation is a
good model for a first step. This can and should be introduced concurrently
with other legislation in this list.
3. Health Freedom Act v.2
- This bill prohibits health
insurers from accepting federal subsidies under the Affordable Care Act that trigger
the employer mandate. Health insurers accepting subsidies shall have their
license to issue new business suspended for all business on exchanges
established by the Affordable Care Act.
4. Insurance Commissioner
- A narrow bill to prohibit
the state Commissioner of Insurance from investigating or enforcing any alleged
violation of federal health insurance requirements mandated by the ACA.
5. Reject grants
- A bill to expressly reject
ACA discretionary grants that aid in the federal takeover of state health
insurance regulation.
6. Stop state executive action
- In order to act as a
legislative check on agency and executive branch implementation of the ACA, a
bill should be introduced to empower legislators to investigate how much their
state is spending on implementation, and ensure that ACA-compliant governors
gain legislative approval before taking any further action.
7. Ban Medicaid expansion
- As envisioned by the ACA’s
authors, the Medicaid expansion would account for roughly half of the law’s $2
trillion of new entitlement spending over the first 10 years. The Supreme Court
blocked Congress’ attempt to coerce states into implementing and, 25 states
refused to do so. As a result, those states have already defunded almost a
quarter of the ACA’s new entitlement
spending. They are also helping to increase dissatisfaction with the law
among hospitals and other providers that won’t receive the subsidies they were
promised in return for their support. Legislation to ban this expansion should
be introduced in states that have a) banned it by executive action only and b) not taken any action to prevent the expansion.
8. Ban the operation of a state-run
exchange
34 states have banned the
creation of state-run exchanges under the ACA. Legislation to ban such action
should be introduced in states that have a) banned it by executive action only
and b) not taken any action to prohibit the operation of an exchange.
9. Prohibit enforcement of liens
- States can pass legislation
to prohibit city/county clerks from enforcing any IRS liens resulting from
nonpayment of the ACA fine/tax. They can do the same with state-chartered
banks.
10. Comprehensive anti-commandeering
legislation
- In conjunction with narrow
bill(s) addressing specific areas from above, an all-encompassing bill to ban
state participation in any and all portions of ACA implementation should be
considered for introduction. Recognizing that passage of just one bill in a
state session can take every ounce of time and energy that a state legislator
has available, introduction by one person of all ten bills listed above is not
sound strategy. We recommend that an interested legislator contact state
legislative leadership to gauge support for one or more of the narrow steps
forward and introduce a bill that is most likely to make progress and pass.
Concurrently, to build support for future action, another portion or a
comprehensive bill should be introduced and used as a tool to educate the
public and other legislators alike.
Comments
This is a good first step, however, employers are still
on the hook with the 50 employee and 30 hour workweek rules that impede job
growth and family income. Medical providers are still on the hook with
Obamacare regulations that increase already ridiculous costs.
The next economy crasher is EPA air and water regulations
that need to be nullified by the Gold Dome. A fuller list of Georgia
legislation needed is as follows:
Repeal Regionalism: Repeal HB 1216 that
created regional commissions for economic development. Repeal HB 277 that allowed Regional tax votes
violating “home rule”.
Increase Employment: Nullify Obamacare to end
the 30 hour rule and allow healthcare providers to dump costly and unnecessary
regulations and lower costs. Ban further immigration in Georgia to allow
unemployment to subside.
Keep Energy Prices Low: Nullify EPA Carbon
Rules. The State can protect electric power consumers from the global warming
hoax by refusing to comply with unconstitutional federal regulations.
Pass Georgia Sovereignty Laws to protect
Georgia citizens from unconstitutional federal laws and regulations and protect
property owners from federal seizure, interference and abuse. Pass Georgia Property Rights Laws that
protect property owners from government abuse at all levels.
Remove Common Core from Georgia and claim
that federal involvement in education is unconstitutional.
Remove eligibility for all tax funded
benefits from illegal aliens including drivers licenses, public schooling,
medical care, in-state tuition and discrimination rules.
Cancel Georgia’s application to the Article V
Convention of States. It’s too dangerous
to do this with the bad guys in charge.
Restrict all “economic development” funds and
activities to returning manufacturing to Georgia.
Ban all Agenda 21 implementation in Georgia.
Restrict campaign contributions to be made by
registered voters and only for candidates who would appear on their ballot.
Limit property tax increases to 3% per year
to avoid large increases like those experienced by Hall County in 2014.
Limit government borrowing power from 10% of
the tax registry to 100% of the government entities’ assets.
Require voter approval for all Bonds for all
government entities wish to sell.
Norb Leahy,
Dunwoody GA Tea Party Leader