During a meeting with the country’s governors yesterday, President Obama endorsed a Senate amendment that would allow states more flexibility in opting-out of provisions of the Patient Protection and Affordable Care Act (PPACA). While this endorsement is part of the president’s bipartisan outreach on health care, the proposed plan does come with caveats.
A provision within the PPACA allows for states to opt-out of many of the law’s provision beginning in 2017 as long as it can create a plan that would provide the same amount of coverage for the same cost to the same number of people as PPACA. Many governors were concerned that the 2017 deadline was too late, that by the time the opt-out period began many of the law’s provisions (including the exchanges and mandates) would be well in-place, making it nearly impossible for them to create competing plans. The amendment in the Senate – sponsored by Senators Ron Wyden (D-OR), Mary Landrieu (D-LA), and Scott Brown (R-MA) – moves the deadline up to 2014, which is the same year the state exchanges are required to be in place as well as the individual and employer mandates take effect. This would theoretically allow the states to create an alternate health care plan to PPACA and have it ready to implement before many requirements take place in 2014.
“I think that’s a reasonable proposal. I support it,” said the president. “It will give you more flexibility more quickly, while still guaranteeing the American people reform. If your state can create a plan that covers as many people as affordably and comprehensively as the Affordable Care Act does – without increasing the deficit – you can implement that plan. And we’ll work with you to do it.”
However, the requirements for the new plans are fairly stringent and may discourage states from creating an alternate. The state plans must cover as many people as PPACA, the insurance offered would have to be as comprehensive as PPACA’s offerings, and the plan cannot add to the federal deficit. It is also subject to approval by the federal government. Some Republicans have criticized this plan as not enough of a compromise that offers no relief to the states.
“This offers a little bit of flexibility, which I think is a positive thing,” said Kansas governor Sam Brownback, “but it doesn’t change the overall objection to the bill.”
According to an aide to Senator Ron Wyden, three states so far have expressed interest in a waiver: Oregon, Massachusetts, and Vermont.