A number of Republican-controlled states opposed to Obamacare are finding new ways to prevent implementation of the healthcare reform law, ranging from refusing to enforce consumer protections to preventing consultations to help people enroll.
According to The Washington Post
, Missouri has even barred local officials from doing anything to help implement the Affordable Care Act passed in 2010 to help provide access to coverage for 50 million uninsured, most of them poor or disadvantaged in some way.
The law was also designed to help middle class Americans who lost their healthcare coverage, along with their jobs, during the recession and are still struggling to find affordable insurance.
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Many of the Republican-controlled states had already made it clear that they don't intend to cooperate or comply with the healthcare law by refusing to expand Medicaid or set up online insurance exchanges, both key components of Obamacare. But the Post reports that many of them are now going even further to thwart the law by refusing to enforce its consumer protections and by restricting the "navigators," or federally funded consultants, hired to help people enroll and decide what coverage plan works best for them.
At the moment, roughly six states — Alabama, Arizona, Florida, Missouri, Texas, and Wyoming — say they don't intend to monitor consumer provisions of the law that bar insurers from rejecting applicants with preexisting conditions or that requires insurers to spend at least 80 percent of patient premiums on medical care.
Their "hands-off approach to enforcing the law" is unusual, the Post reported, given the fact that insurance regulation is a key element of a state's authority. Giving it up to the federal government, which does not really regulate insurance, is a big step, Sara Rosenbaum, a health law professor at George Washington University, told the Post.
"The thing that’s so striking about it is that the power of states to regulate insurance is considered one of the most sacrosanct powers in the states’ quivers," she said. "Compared to the other ways these states have chosen to completely ignore the existence of this law, this one is a quantum leap."
According to the Post, more than a dozen GOP states have also reportedly imposed licensing rules and limits on navigators, making it more difficult, if not impossible, for people to sign up for coverage. In Ohio, for example, navigators won't be allowed to compare and contrast plans for customers, while in Missouri they won't be allowed to even talk to potential consumers who have already talked to a professional insurance broker or agent.
Ed Haislmaier, a senior fellow at the conservative Heritage Foundation, says even though some of the actions by states may be politically motivated, they are still justified.
"It is very important for people to understand that [Obamacare] is not necessarily a good deal for states, and it is quite in the interest of states to do what they are doing," he told the Post. "It is very important for people to understand this is not all political or intended as its principle purpose to harm the legislation."
In Missouri, which rejected both the law's Medicaid expansion and health insurance exchange provisions, has taken perhaps the most strident measure. Last year, voters there approved an initiative prohibiting state and local officials from doing anything to help
implement the law.
"They don't want it, so we are just following what our citizens want," GOP state Sen. David Sater told the Post. "It's federalism," he added. "It's the federal government trying to tell us whether we can go to the bathroom or not. It's ridiculous."
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