Earlier this year, near the close of the legislative session, the Advance Arkansas Institute argued that our state legislature should do nothing to advance Obamacare (for instance, it shouldn't establish a state insurance exchange) until some of the many uncertainties surrounding the program were clarified. In our paper analyzing the Beebe Administration's proposal to establish a state exchange, Lawmakers Who Want to Surrender Even More Control over Health Care Policy Should Love HB 2138, we argued that the inferior product that the Beebe Administration had presented to the legislature on a take-it-or-leave-it basis should be rejected, and that lawmakers should consider establishing an alternate exchange which would better serve Arkansans health care needs. (The choice that Obamacare offers is that, unless a state establishes its own exchange, the federal government will swoop in and establish one for us.)
Since then, however, the prospects for the successful implementation of health care reform have continued to worsen. The federal government issued hundreds of pages of regulations that further constrain the possibilities of efficiency in a state health care exchange, and a fascinating new paper by John Graham of the Pacific Research Institute demonstrated that it is nearly impossible that more than a third of the nation's population will be under state exchanges by the 2014 deadline. Journalist David Hogberg discovered that a bug in the federal legislation makes it impossible for federal exchanges to offer the subsidies to consumers that are supposed to make Obamacare work. The establishment of a federal exchange will be nearly impossible for an additional reason: federal funding will almost certainly be unavailable for the foreseeable future. In short, Obamacare is in critical condition, and the resources it needs for life support are unavailable.
This means that conservatives in state legislatures in Arkansas, and across the country, have it within their power to block the establishment of Obamacare. They just need to hold firm and resist the entreaties of liberals to establish an exchange on the state level. Will Arkansas legislators have the courage to let Obamacare wither and die?