As major provisions of Obamacare are rolled out, opponents of the reform measures have gone desperate and resorted to an assortment of unscrupulous tactics to block its implementation. On the federal level, some Republicans called for threatening to shut down the government to defund the law, and two weeks ago I explained here why that is a bad idea. In some states where Republicans control legislatures and governors' mansions, they rejected the expansion of Medicaid coverage for more low income people and balk at setting up insurance exchanges where shoppers can select health plans best for them.
However, these two methods are only the more well-known and explicit ways for recalcitrant state governments to obstruct Obamacare, and in addition to them they have utilized three indirect and unconventional ways to prevent individuals from accessing coverage through the new law. They typically involve deliberately adding layers of bureaucratic nightmares to make the process of getting insurance harder. As reform opponents frequently decry Obamacare for creating new bureaucracy, these tactics reveal their hypocrisy.
As the new law enables tens of millions of uninsured to purchase insurance, many among these individuals need guidance to know how the new system works and advice on how to get the best coverage, from the state exchanges or otherwise. For this purpose, states are to allow workers called "Navigators" to help and educate people in getting through the process to become covered. While they may be funded by the federal and state governments, some funding and training come from private and nonprofit organizations.
So, if the Navigators are prevented from effectively carrying out their duties, many will be left in confusion not knowing how to obtain insurance under Obamacare. Republican politicians in several states are trying to make exactly that happen. In Georgia, the government requires Navigators to pass state insurance-agent test and get a license from the state. The state's insurance commissioner, Ralph Hudgens, admitted openly in a speech that the licensing requirement was crafted with the purpose of obstructing Obamacare. In Ohio, Navigators are banned from talking about how plans compare and contrast with one another and the state imposes strict certification requirements on who can become a Navigator.
In Missouri, the state government opt not to start its exchange and left the job to the federal government. But on top of that, a law was passed to disallow any public officials in the state to "cooperate" with the federal exchange. As a result, if you are a resident of Missouri, and you run into a state employee and ask him or her where you can access the federal exchange, or how it works, that person cannot legally tell you anything, no matter how much the employee knows or how much he or she wants to help you out. John Huff, Missouri's insurance regulator, even feared that being interviewed by a reporter about the exchange would violate the law and thus avoided speaking to the media.
In effect, this works as a gag order, and has pretty much turned the federal exchange into an underground organization, with many citizens unable to find it when looking to be covered. There is someone who serves as Missouri's "Affordable Care Act coordinator" but he does not appear on the state employees' roster, operating under the sponsorship of a nonprofit called the Missouri Foundation for Health. This stonewall tactic is in the detriment of those 877,000 uninsured in the state as weaving through this bureaucratic labyrinth to buy insurance can be as difficult as looking for illegal goods in the black market.
A key part of Obamacare is to ensure people are not denied from procuring insurance due to their pre-existing conditions. Generally, states are to enforce this provision, as are most insurance regulations. However, six states, including Texas, Oklahoma, and Arizona, have indicated they would not implement this rule, allowing insurance companies to continue to reject patients until whenever the federal government decides to step in and intervene.
These three kinds of actions taken by states are intended to add more inefficiency and complication to the implementation of Obamacare, in order to make it messy, unsuccessful endeavor. For opponents of the law, if they succeed in sabotaging it they would then claim Obamacare is doomed to fail from the beginning.
A very cynical ploy indeed. Recent data has shown that in "blue" states where politicians want Obamacare to succeed, the premiums fell while in "red" states, including ones using the tactics above, the price of insurance spiked.