Coulter says RomneyCare was meant to address the “free-rider problem,” of people not paying for emergency room treatment that EMTALA forces doctors to provide.  As I’ve written, the rationale that mandatory insurance prevents cost-shifting from the uninsured is bogus.  Mandatory insurance introduces more free-riding.

Further, as Philip Klein writes in his response to Coulter, titled “Coulter’s shameful defense of Romneycare“:

The numbers show that the cost to government of expanding coverage to lower-income residents far exceeded any marginal savings from lower uncompensated care costs.

Klein’s rebuttals to Coulter’s other points are worth reading.

Coulter writes:

States have been forcing people to do things from the beginning of the republic: drilling for the militia, taking blood tests before marriage, paying for public schools, registering property titles and waiting in line for six hours at the Department of Motor Vehicles in order to drive.

At HotAir.com, AllahPundit has an excellent rebuttal to this point:

Once you accept that State Mandate Y should be tolerated because people already tolerate State Mandate X, you’ve built yourself a self-perpetuating government expansion machine. Why not let the state mandate people’s diets while we’re at it? After all, we let them force militia-age males to carry guns.

Read AllahPundit’s whole post: Ann Coulter: “Three cheers for RomneyCare”

In the American Spectator, James Antle III counters Coulter’s claim that “What went wrong with Romneycare wasn’t a problem in the bill, but a problem in Massachusetts: Democrats.” Antle writes:

In the case of Romneycare, while it is true that the Democrats pushed some details to the left, the basic architecture of the plan — mandates, subsidies, government-run exchanges, and expanded Medicaid — were all in the original proposal backed by the governor. The final product didn’t differ in kind from Romney’s proposal, though it did to some extent by degree. And Romney had already decided not to run for reelection, thus leaving the plan’s implementation totally up to Democrats.

Phillip Klein adds:

To start, Romney signed the health care law with a smiling Ted Kennedy at his side knowing that Democrats had the votes to override any symbolic line-item vetoes of certain provisions. Furthermore, when he signed the law, he had already announced he wasn’t seeking reelection as governor and knew that it would almost certainly fall on Democrats to implement the law. Part of being a limited government Republican is realizing that once you put the infrastructure in place, successors can always add to it.

Author and Radio talk show host Mark Levin has a two-part rebuttal, line-by-line in Coulter’s argument, on YouTube, here & here.

(Via FIRM, HealthCareBS, photo via Washington Examiner)

Republicans will [soon] get back to doing what they do best, getting on Barack Obama’s case. Incredibly, though, they’ll have to do it without one of their most potent arguments.The Republican candidate, after all, can’t effectively attack what he supports. Today both leading contenders for the nomination have defended the idea of government’s forcing all consumers to buy something in the interest of the common good. …

Why did [Newt] change his mind? Even if he provides a compelling answer, it’ll be too late. (“For 20 years, even conservative icon Newt Gingrich supported the basis of the president’s health care plan. … I’m Barack Obama, and I approved this message.”)

via The GOP’s ObamaCare Problem – Reason Magazine.

Mr. Romney has indeed backed himself into a corner by insisting on defending his health plan while attacking ObamaCare. In the Oct. 11 debate at Dartmouth College, Mr. Romney said: “[W]e all agree about repeal and replace. And I’m proud of the fact that I put together a plan that says what I’m going to replace it with.”

Does he really mean that he wants to use Massachusetts as a model for his “replacement” plan? No wonder voters are worried.

Unless Mr. Romney takes steps to conform his position with reality, he will have trouble convincing voters he is serious about repeal and will have an even harder time mapping a clear plan on health reform should he be elected president.

Read the whole article: Grace-Marie Turner: Scoring Last Week’s RomneyCare Debate – WSJ.com.

As Michael Cannon at Cato summarizes:

The basic theorem is this: market actors have greater incentives to prevent fraud, because it’s their own money on the line.  Politicians are spending other people’s money, so their incentive to prevent fraud is far less.  Therefore, fraud will always be higher in government programs than in similar market endeavors.

And here’s a shocker: Medicare & Medicaid fraud far exceeds insurance company profits.

Here’s the bill summary. (The absence of capital letters is in the original bill.)

SB 12-060 – Improve Medicaid fraud prosecution
Sponsor: Senator Ellen Roberts
Description: The bill requires the department of health care policy and financing (HCPF) to submit a written report annually to the health and environment committee and the judiciary committee of the house of representatives and to the health and human services and judiciary committees of the senate concerning client fraud in the medical assistance program. In addition, the attorney general’s office is required to submit a written report annually concerning provider fraud.

The bill also changes the amount of a county’s share of recoveries of fraudulently obtained medical assistance when the recovery is initiated by a county department, county board, district attorney, or HCPF on behalf of the county. Instead of sharing one-half of the state funds paid with the state, the county may retain the full amount of the recovery after payment of the federal government’s share.
Hearing: Senate Health and Human Services at 1:30 PM in SCR 356
Contact the Senate Health and Human Services Committee by clicking here

Via Colorado Senate News.

Sen. Tim Neville, R-Littleton, said he sponsored Senate Bill 53 because he does not believe in the state or federal government mandating health care purchases or setting minimal requirements that must be in a health insurance plan.

The Citizens Council on Health Freedom recently sent out the following e-mail (which may be published a Health Freedom Watch) that summarizes key points about why repealing Colorado’s Health Benefits Exchange (SB 11-200) is a good idea:

Michael Cannon from the Cato Institute in Washington, D.C. came to Minnesota late last year to discuss Obama’s government-established health insurance “exchange” with Republican legislators. Here’s the video with an intro by CCHF’s president. Here’s part of what Mr. Cannon says (Comments start at 2:45; Q&A begin at 32.17):

 You do not want to create an Obamacare health insurance exchange. You do not want to create any type of health insurance exchange….Obamacare is not just any old law. It is the most sweeping piece of economic regulation that Congress has passed in our lifetimes, in any of our lifetimes….It sweeps 2/3 of of this country, 200 million people, into compulsory health insurance.” Just one regulation in Obamacare is going to throw 155,000 Americans, not just Americans, sick Americans, out of their health plans where they’re protected from insurance spikes….because this regulation is going to force their insurers out of business.

Dumping the “Dogs”

Cannon warns that “the most persuasive reason” for legislators to not create an Obamacare exchange is because those [Obamacare price controls] give insurance companies “a $999,999 incentive to avoid, dump and mistreat sick people…” He says health plans with price controls drop certain coverage “precisely so they could get rid of the “dogs.”" That word came from a internal memorandum, he says. “Dogs” was the term used to describe high cost patients that needed to be dumped.

 Obama “Dying to Have States Create Exchanges”

He says the Obama Administration is

dying to have states create exchanges…They want it to be a state exchange, so they don’t have to administer it, so that someone else will take the bullet for them when Obamacare starts hurting sick people, so that there won’t be this cloud over whether or not they are able to offer the premium assistance that hides much of the cost of Obamacare. [the tax subsidies]

“Let the Federal Government do it”

Cannon discusses whether state-run Obamacare-compliant exchanges do not preserve power for the state. “You’re not mandated to do this.” He says, the administration is giving you the option of running an exchange that you would run yourself with the “federal exchange” as a fallback. But Cannon says, “Don’t do it yourself, let the federal government do it. I understand why that’s counter-intuitive.

Power Has Shifted

“…The biggest argument among opponents of Obamacare as to why they should never none-the-less create an exchange is it will allow you to preserve state control. I want to tell you that that that is false….If you want proof of that, listen to the people who are creating an exchange to preserve state autonomy,

• “Once our exchange is approved…
• We will get authority from the federal government to…
• We will get sign-off from the federal government on….
• The federal government will allow us to…. “

Cannon says:

The power has already shifted from the states to the federal government. If you create a state-run exchange you’re not enhancing your authority. You’re not preserving state authority. All you’re doing is lending power manpower to a federal takeover that has already happened.

Thus, the state GOP legislators must say NO, NO, NO to the exchange.

The state Department of Health Care Policy and Financing has failed to implement 51 audit recommendations that it agreed to accept during the past two years, auditors told a panel of lawmakers Thursday.

Most serious, auditors said, are failure to properly document proof that Medicaid recipients are eligible for the program and deficiencies in record-keeping that assures health care providers are approved to treat Medicaid patients.

Some lawmakers who attended the joint meeting of the House and Senate health committees expressed outrage that the practices recommended to remedy problems were delayed, in some cases multiple times.

“As a taxpayer, it’s kind of insulting,” said Sen. Joyce Foster, D-Denver. “I am so frustrated with this kind of bureaucracy. I guess that’s what leads to people concerned about big government.”

Read the whole article: Auditors rip state health care department – The Pueblo Chieftain.

Via Ari Armstrong.

On behalf of the Independence Institute, Rob Natelson and I wrote an amicus brief on the Medicaid mandate currently before the Supreme Court. (The ACA requirement that states must drastically expand Medicaid eligibility, or lose all their federal matching funds for Medicaid.)

Read the summary at The Volokh Conspiracy » Independence Institute brief on Medicaid mandate.

Are you having difficulty finding a doctor who will see you? If you are, brace yourself. Things are about to get a whole lot worse.

Right now, the biggest problems are in Massachusetts. …For the state as a whole, the average wait to see a new family doctor is one month. More than half of all family doctors and more than half of all internists are not accepting new patients at all.

What if you live in another state? Just wait two more years. In Massachusetts people are lined up waiting to see doctors because of the health reform championed by the former governor (RomneyCare). And as Barack Obama has said on more than one occasion, RomneyCare is the model for ObamaCare.

Why? In both the Massachusetts health plan and the new health care law the mistake is the same: insuring the uninsured, but doing nothing to enable the medical community to deliver more care.

Read the whole article: Why the Doctor Won’t See You – John C. Goodman.

(Via FIRM)

• Obamacare, signed in March 2010, has not reduced the rate of growth of health-insurance premiums, which increased by 20 percent in the small group market between 2008 and 2010.
• Obamacare subsidizes states to increase political control of health-insurance premiums, although there continues to be no evidence that such interference reduces the rate of growth of premiums.
• When monitoring competition, government regulators use a measurement of market concentration that does poorly when applied to choice in health insurance.
• New evidence continues to support the conclusion that Obamacare will lead to less choice of health insurance.

Read the whole thing: Over Regulation Reduces Choice in Health Insurance: An Update.

The bill requires the department of health care policy and
financing (state department) to seek a federal waiver to allow for increased flexibility and efficiency in the management of the medicaid program and the children’s basic health plan.

The waiver will seek authorization to determine eligibility
categories and income levels and to establish an asset test for eligibility, implement cost-sharing and premiums, encourage the use of private health benefits coverage, and encourage persons to maintain employer-sponsored health insurance. As part of the waiver, the state department may negotiate for capped federal reimbursements with provisions for adjustments in the federal reimbursements for population growth and inflation.

The state department shall report to the general assembly
concerning the waiver request and identify necessary changes to state law to implement the reforms requested in the waiver.

My take:

Cost-sharing and premiums:  I assume this means increasing them. This is a good idea, as I discussed in this article at Health Policy Solutions: Colorado Child Health Plan: Parents should value children’s health more than sweets and booze.

Encouraging this use of (nominally) private health plans: The bill text says: “Encourage the use of the private health benefits coverage market rather than public benefits systems.” This is also a good idea. Medicaid is a dreadful program in terms of access to care, fraud, and cost to taxpayers.  See also “Medicaid’s Unseen Costs” by Michael Cannon.

If the political left approves of food stamps (food vouchers for private grocery stores) rather than government-run grocery stores for the poor, then why not the same for health plans?

Florida has tried this, and according to the Heritage Foundation it has been successful. (I need to read up on this myself.)

Capping federal funding: Matching funds from the Feds is a disaster. It encourages waste and rewards Colorado bureaucrats for spending taxpayers’ money. For more, read my posts about Medicaid Block Grants. Or watch the video above for a summary.

Thanks to Colorado Senate News for informing me about this bill.

Tim Hoover of the Denver Post comments here: Republican senator files bill to force state to seek Medicaid waiver.