Governor Nikki Haley today released a letter she wrote U.S. Sen. Jim DeMint regarding the Patient Protection and Affordable Care Act (ACA) and health exchanges in South Carolina. A copy of the governor's letter to Sen. DeMint is attached.
In the wake of the Supreme Court's ruling on the Patient Protection and Affordable Care Act, Sen. DeMint urged governors across the nation "to stop implementing the health care exchanges that would help implement the harmful effects of this misguided law. Americans have loudly rejected this federal takeover of health care, and governors should join with the people and reject its implementation." (Press Release, Office of U.S. Senator Jim DeMint, 6/28/2012) Sen. DeMint also joined Members of Congress in writing a letter to governors regarding the Patient Protection and Affordable Care Act, asking them "to oppose its implementation" and "oppose any creation of a state health exchange mandated under the President's discredited health care law."
In her letter to Sen. DeMint, Gov. Haley wrote, "South Carolina stands with you and your cosigners in opposing implementation of state-based insurance exchanges -- a decision we have been committed to since it was announced after careful consideration last December
Our analysis of the exchange law found that, among other things: states have little meaningful flexibility under the Obama administration's concept of "state-based"; exchanges are required to assume many administrative functions now performed by the private insurance market; and most notably, the law's primary intent is to create a new system for delivering federal insurance premium subsidies under rules governed by the Internal Revenue Service -- a function where the state has no compelling role.
"Bottom line? By refusing to implement state-based exchanges, the state is ceding nothing -- we were given very little in the first place and, unsurprisingly, asked to give far too much in return. Critics of our decision sometimes forget that states are given a choice, and the law's authors may now wish that they had not written a federal exchange option into the law. It is increasingly clear that without significant state assistance, it will be unlikely that any insurance exchange solution can be implemented at all. With the implications of this choice in mind, combined with the Court's decision properly returning Medicaid expansion decisions to the state and the fact that the "state-based" exchanges are state-based in name only, states opposed to ACA should not freely give up the leverage we now have to repeal and replace this bad law."