JACKSON, Miss. (Jan. 15, 2017) – A bill introduced in the Mississippi Senate would end all state support and cooperation with the implementation and administration of Obamacare. Passage of this bill would set the stage to bring down the federal health care act in Mississippi.
Sen. Michael Watson (R) introduced Senate Bill 2300 (SB2300) Jan. 13. The legislation would prohibit all Mississippi state agencies, political subdivisions and their employees from enforcing any federal rules, acts, orders or regulations designed to give effect to the Affordable Care Act, and from providing material support to federal employees doing the same. It would also bar the use of any state assets or funds for the enforcement of such rules and regulations.
In addition to ending all state cooperation with the implementation and administration of Obamacare, SB2300 would also prohibit state expansion of Medicaid, an important part of the Obamacare plan.
At this point it remains unclear whether Congress will actually send President-elect Trump a bill to repeal Obamacare. If so, will it be a complete or just a partial repeal? Regardless, state actions can help completely bring down the Affordable Care Act.
Obamacare was predicated on state cooperation. By ending state actions that support the ACA and refusing to enforce any of its mandates, a state can make it nearly impossible to run Obamacare within its borders. The federal government never intended to run the healthcare system alone, and ultimately, it can’t do it without state help. We’ve already seen the difficulties created for the Act by the number of states that simply refused to set up exchanges for the federal government.
“The federal government can barely manage running a website,” Tenth Amendment Center Executive Director Michael Boldin said.
Judge Andrew Napolitano noted that if a number of states were to refuse to participate with the ACA in a wholesale fashion, that multi-state action would “gut Obamacare.”
Napolitano said that if enough states follow suit, “it will gut ObamaCare because the federal government does not have the resources or the wherewithal […] to go into each of the individual states.”
For example, the legislation would ban the Mississippi Department of Insurance from investigating or enforcing violations of federally mandated health insurance requirements and said this will “prove particularly problematic for the federal government.”
Insurance commissioners serve as the enforcement arm for insurance regulation in the states. The federal government has no enforcement arm. The feds assumed the state insurance commissioners would enforce all of the provisions of the ACA.
So, when people have issues with their mandated coverage, they will have to call the feds. At this point, it remains unclear who they will even call should the state be prohibited from carrying out this essential task. Issues the state insurance department would not address include prohibiting a denial of insurance for preexisting conditions, requiring dependent coverage for children up to age 26, and proscribing lifetime or yearly dollar limits on coverage of essential health benefits.
This strategy rests on a well-established legal principle known as the anti-commandeering doctrine. Simply put, the federal government cannot force states to help implement or enforce any federal act or program. The anti-commandeering doctrine is based primarily on four Supreme Court cases dating back to 1842. Printz v. US serves as the cornerstone.
“We held in New York that Congress cannot compel the States to enact or enforce a federal regulatory program. Today we hold that Congress cannot circumvent that prohibition by conscripting the States’ officers directly. The Federal Government may neither issue directives requiring the States to address particular problems, nor command the States’ officers, or those of their political subdivisions, to administer or enforce a federal regulatory program. It matters not whether policy making is involved, and no case by case weighing of the burdens or benefits is necessary; such commands are fundamentally incompatible with our constitutional system of dual sovereignty.”
SB2300 was referred to the Senate Medicaid Committee where it will need to pass by a majority vote before moving forward in the legislative process.