In 2010, Congress passed and President Obama signed the Patient Protection and Affordable Care Act (PPACA) amid great controversy. Passage of the bill did not resolve the dispute, and the law has been a source of uncertainty for state governments around the country. Moreover, the Supreme Court’s ruling that the law is constitutional did not resolve the instability:
- There is a substantial likelihood that PPACA opponents in Washington, D.C., will be able to stymie implementation and funding of the law or even repeal it, depending on who ends up controlling the U.S. House of Representatives, the U.S. Senate, and/or the White House after the 2012 elections.
- Multiple provisions of the law, notably services defined as “essential,” are left to the whims of the U.S. Secretary of Health and Human Services and will be readily adjusted by future administrations.
- With the Supreme Court’s recent decision, a movement will surely begin to pass an amendment to the Constitution of the United States making all or part of the law a violation of the founding document.
Therefore, Rhode Island must take the lead — as it has with pension reform and the Global Medicaid Waiver — in ensuring that its residents maintain access to health care service through the maintenance of choices, control of costs through free-market mechanisms, and confidence in the quality of care provided.
Changing Rhode Island’s current arrangement, vis-à-vis health care, must be a top priority for public officials and engaged citizens, alike. The state leads the country in the number of mandates that it imposes on all health plans within its reach. Partially as a result, only three insurers are willing to operate within its borders, and only one of those offers individual plans for direct sale to consumers.
Policy Recommendation: Enact a Health Care Freedom Act for RI Citizens
While there are many policy reforms to consider, the recommendations in a Health Care Freedom Act will put the Ocean State’s health insurance sector back on a path that produces higher levels of competition, provides more choices for consumers, and shields Rhode Island from current and future federal mandates.
- Repeal the governor’s executive order creating PPACA Health Insurance Exchanges.
- Apply for a State Innovation Waiver to free RI from certain provisions of PPACA, including exchanges.
- Enact a Health Care Freedom Act that would:
- Open up competition by allowing interstate sales to permit Rhode Islanders to purchase health insurance plans from approved providers in other states.
- Allow an “opt out” provision from the state’s currently burdensome level of health insurance mandates and require insurers to openly display the original mandates not included.
- Pass an amendment to the state constitution to prohibit the federal government from ever requiring Rhode Island residents to buy health insurance.
- Pass a resolution calling for amendment of the federal Constitution to invalidate PPACA.
Rhode Island faces an important decision: whether or not to continue down the path of creating an exchange as described by the Patient Protection and Affordable Care Act. Beyond that, Rhode Island must decide whether to rely on the promises of the legislation’s supporters that such policies serve to correct the problems American citizens face in finding affordable health insurance.
Download a PDF of the complete policy brief here …