Beshear: GOP playing "politicial games" with health exchange, says he has authority to create it

Governor Steve Beshear said the actions of Republican lawmakers at Wednesday’s interim joint committee on Health and Welfare, “don’t mean anything,” and he will continue to implement the Kentucky Health Benefit Exchange.

Beshear, who is fresh off an economic development trip to India, said he has the authority to create the exchange through executive order. And he said it was prudent for Kentucky to do so because the Affordable Care Act, which was upheld by the U.S. Supreme Court in June, calls for some type of system to match the uninsured with health coverage. If Kentucky’s government didn’t set up the exchange, the federal government would and it would penalize the state.

“Some of these folks just want to play political games, and I understand it. I guess it’s an election year. I don’t have time for it. I have to run this state. I have to make things happen. And I have to comply with federal law, and that’s what I’m stepping out to do,” Beshear said.

Beshear spoke with Pure Politics while in Lexington attending the official public welcome ceremony for international law firm Bingham McCutchen LLC, which is moving its administrative office there.

The exchange is the entity that will match up uninsured Kentuckians with private health insurance. It will specifically serve those who make too much money to qualify for Medicaid but don’t have insurance through their jobs.

Republicans, led by Sen. David Givens of Greensburg, said during a legislative health and welfare committee meeting Wednesday that the governor didn’t have the authority to create a new agency with new functions without legislative approval. When Democratic lawmakers walked out, the Republicans voted by voice on a motion to reject Beshear’s executive order creating the exchange as a new agency under the Health and Family Services Cabinet.

There are at least six ways the Exchange is not "consumer-friendly." First, the purpose of the Exchange is universal health care, which is not "consumer-friendly." Second, those who are Medicaid-eligible will be automatically enrolled in Medicaid, even if they don't want to be. There will be no shopping in the "marketplace." Third, the only available health plans on the Exchange will be those approved by the State and by law that list could be further limited by the federal government. That's not a market for consumers. Fourth, putting employers in jeopardy of significant fines if even one employee receives a premium subsidy on the Exchange is not "consumer-friendly." Fifth, a 12-member research group on exchanges recently revealed that the Exchanges are actually very "complicated," and at least one member suggested providing "defaults for people that are simple and good enough." Defaults are choices determined by government, not individual consumers. And sixth, it is not "consumer-friendly" to gain access to private medical records without patient consent .

The goal of "eliminating health disparities" has been recognized as the advance of universal health care. The term "health disparities" has been broadly defined to mean health care based on race, ethnicity, sex, age, disability, sexual identity, geography, and socioeconomic status, to name a few. Eliminating so-called "health disparities" will mean intrusive data collection and analysis of individuals and their doctors. It could potentially lead to mandated treatments and mandated availability of certain types of practitioners regardless of the consumer's wishes.

There are no definitions in these exchange draft principles. For example, how is "high quality" defined and who determines the definition? Who decides and defines "value"? The public has been led to believe that the Exchange is solely about buying health insurance. This principle makes it clear that the Exchange will delve into the medical records of patients and the medical decisions of doctors to determine physician compliance with the government's definition of "quality" and "value" -- and through payment mechanisms financially penalize any physician, hospital or other practitioner that opts to individualize and customize care outside government definitions.

Competition happens in a free market, not a government-imposed bureaucracy claiming to be a market. The State will decide winners and losers. Those who refuse to play by government rules, those who refuse to cooperate or are not big enough to comply with all the government's regulations will lose. They won't even be allowed to compete. Competition happens naturally every day without, and often in spite of government interference. The Exchange, under the authority of the federal government and run by either the state or federal government, will both make and impose the rules. This is not competition— and the Exchange is not a marketplace.

this is an example of opposition to the MN "exchange" they're trying to force on us here as well...

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