As Republicans run out of alternatives to Mitt Romney (who gave us the model for the Affordable Care Act) a new question arises for state-level elected officials: would you opt the state out of health reform?
It’s a relevant question because Romney says  the first thing he would do in office is issue an executive order granting waivers from health reform to all 50 states. It is not clear who would apply for the waiver. Would that be the responsibility of the governor or the legislature? We don’t know. That is why everyone should be asked the question.
It might seem like a straightforward answer. The North Carolina General Assembly did vote to “exempt” state residents from the individual mandate. But Republican politicians tried to slide and slip around the assertion that they were opposing all of health reform. The House even broke with Republicans in nearly every other state in aggressively implementing an “Obamacare” exchange.
A waiver from reform would mean that seniors would immediately pay more for prescription drugs in Medicare Part D. Young adults would get booted from insurance plans. Businesses would lose tax credits for offering health coverage. Insurance companies would reinstitute caps on how much they will pay out in annual and lifetime benefits. Insurance companies would no longer have to spend a certain percentage of premium dollars on health care. Preventive visits to the doctor would require co-pays once more. Women would go on getting charged more than men for the same coverage. And we would forever live with our pre-existing conditions.
I’m not sure that politicians have ever stripped away such a comprehensive package of benefits from the people they represent. It would be a tremendous, and tremendously damaging, move. There are indications that the legislature would apply for such a waiver. Along with attempting to subvert the individual responsibility requirement in health reform, Republican legislators also retained a law firm to join the Florida lawsuit against the Affordable Care Act. That lawsuit specifically seeks to overturn the entire law, not just the mandate.
Would the General Assembly yank health coverage for kids and jack up drug prices for seniors? Would Gov. Bev Perdue or candidate Pat McCrory reject reform and embrace pre-existing condition exclusions? I don’t know, but someone should ask. Our lives, literally, depend on it.