This Friday will determine if Arizona creates a state-run, online marketplace for consumers to use when choosing health plans, or lets the federal government create and run a so-called “exchange” for the state. The issue has many people in Arizona concerned about their businesses and cost.
Brewer is among the Republican governors who oppose the law, but she has yet to indicate what course she’ll take, although the governor has received many phone calls and e-mails opposing the new federal health care law. The Govenor’s administration has spent millions of dollars of federal grant money on planning and preliminary work for creating a health exchange.
Brewer has said her administration has done a lot of planning to be prepared, but also indicated she was still studying the issue and hadn’t made a decision.
“I’ve got to decide (whether) it’s the right thing for Arizona,” Brewer said while noting she will need legislative approval.
Senate Health Committee Chairman Nancy Barto offered a similar assessment of legislative leanings but said Brewer’s office “at least on the exchange seems committed to take a chance on Obamacare.”
On a related health care law issue with similar state vs. federal considerations, Brewer decided it was better to have the state run its own program to review health insurance rates than let the federal government handle it.
Conservative groups such as the Goldwater Institute and Americans for Prosperity are calling for Brewer to stiff-arm the federal law’s mandate for an exchange. Meanwhile, social-service advocacy groups are weighing in with calls for the state to create an exchange that is friendly to consumers on affordability, convenience and oversight.
Some experts have weighed in that Brewer doesn’t even have the authority under the state constitution to implement the exchange. Why? Because in 2010, voters there passed the Arizona Health Freedom Amendment to the state Constitution, which reads in part:
A LAW OR RULE SHALL NOT COMPEL, DIRECTLY OR INDIRECTLY, ANY PERSON, EMPLOYER OR HEALTH CARE PROVIDER TO PARTICIPATE IN ANY HEALTH CARE SYSTEM.
“Compel” – in a legal sense – includes the levying of penalties or fines
According to Michael Cannon of the CATO Institute, in order to operate an exchange, Arizona employees would have to determine eligibility for ObamaCare’s “premium assistance tax credits.” Those tax credits trigger penalties against employers (under the employer mandate) and residents (under the individual mandate). In addition, Arizona employees would have to determine whether employers’ health benefits are “affordable.” A negative determination results in fines against the employer. These are key functions of an exchange.
Ergo, if Arizona passes a law establishing an exchange, then that law would violate the state’s constitution by indirectly compelling employers and individual residents to participate in a health care system. That sort of law seems precisely what the Constitutional Amendment exists to prevent.