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North Jersey - Health Care Act: -Guilty as Charged

Op-Ed

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ON JAN. 1, 2014 -- the date on which the Health Care Act's individual mandate, federally subsidized state health exchanges and an unprecedented Medicaid expansion each take effect -- the outstretched and cradling arms of big government will lure millions of new Americans into his embrace, putting our nation firmly on the path to insolvency.

LANCE THEROUX / THE RECORD
The left's heavy-handed approach to health reform will not make health insurance more affordable, improve the quality of care or increase coverage. Rather, the Health Care Act will do the exact opposite, and very likely bring the economy down with it.

With our nation on the brink of slipping back into recession and unemployment at record levels, this package represents a full assault against economic recovery and should be held guilty as such.

While I recognize that a law cannot be indicted under our criminal justice system, the courts of public opinion and political discourse provide an appropriate forum for the Health Care Act to stand trial.

The following is a simple and straightforward three-count indictment against the president's health care law -- an indictment that proves the law is guilty as charged and must face the only sentence that fits the crime: full repeal.

Count One: The act is strangling job creation.

According to a National Federation of Independent Business index that tracks business confidence, optimism among small-business owners in June dropped to its lowest level since October 2011. If small-business owners are feeling uncertain about the costs of health care or the massive tax increases under this Health Care Act, they are unlikely to expand and hire additional workers. Under the law's slew of mandates and taxes, many employers will face higher health insurance costs.

An NFIB report estimates that the law's health-insurance-premium tax could raise employer-sponsored premiums by as much as 3 percent, and impose a cumulative cost of nearly $5,000 per family by 2020.

Further, the non-partisan Congressional Budget Office estimates that the employer mandate under the Health Care Act -- which requires firms with 50 or more employees to offer mandated coverage or face a tax -- will cost businesses $52 billion in tax penalties between 2014 and 2019.

In these tight economic times, with business owners laser-focused on their bottom lines, the Health Care Act's numerous mandates and taxes are nothing more than certified job killers.

Count Two: The act will destroy Medicare and Medicaid.

Even without the weight of this act, Medicare and Medicaid are already on the path to bankruptcy. With the Health Care Act, the situation is even worse. The president's health care law raids Medicare by more than $500 billion and creates a Medicare rationing board -- a group of 15 unelected bureaucrats -- to slow the growth of Medicare spending.

Not only does the law cut Medicare, but it also fails to save the program to ensure we can cover the cost of current and future retirees.

The situation with Medicaid is not much better. In fact, the law drastically expands Medicaid, putting millions of more Americans on government health insurance. In fact, by 2020, according to a non-partisan Centers for Medicare and Medicaid Services' estimate, one-in-four Americans will be enrolled in Medicaid. This is simply not sustainable.

And while the health care package initially covers the states' share of costs of new enrollees, this sweet deal -- at the expense of the American taxpayer -- doesn't last forever. With state budgets already buckling under the pressure of Medicaid, in the end taxpayers will be left footing the bill.

Count Three: The Health Care Act is recklessly blocking implementation of real health care reform.

To reform our health care system, we need to do better than a government takeover of health care. And make no mistake, real solutions are within our grasp.

To increase coverage, we should expand tax breaks in the employer-sponsored market to the individual market, and expand tax-free health savings accounts. We should increase competition among insurers, allow small businesses and individuals to pool risk and allow health insurance sales across state lines.

In addition, we must reform Medicare by providing seniors greater choices and harnessing the power of competition to drive down long-term costs. And we must save Medicaid for those who are truly needy by giving states the flexibility to meet their distinct needs.

Even though Chief Justice Roberts and the Supreme Court have deemed the Health Care Act constitutional using an artful combination of sleight-of-hand illusion and tortured legal reasoning, the president's signature health care law still stands to erode American freedom and remains an anvil on the wings of our dynamic free enterprise system.

In fact, I believe that the damage that the law has already inflicted -- and to a greater degree, will continue to inflict -- can be reversed only through total repeal of the law. For the reasons outlined above, I believe that the Health Care Act is guilty of crimes against the economy.

Let's give the law the only sentence it deserves: full repeal.

Scott Garrett, R-Wantage, represents New Jersey's 5th congressional district. He is the vice-chairman of the House Budget Committee and founder and chairman of the Congressional Constitution Caucus.

Thanks to the Supreme Court's decision to uphold President Obama's health care law, this waitress, and millions like her across the country, will be able to enroll in Medicaid, the federal-state partnership program that provides health insurance to the poorest Americans.

All in all, the Kaiser Family Foundation estimates that more than 550,000 New Jerseyans who can't afford health insurance could gain coverage through the expansion of this critical program.

These reforms are much needed and long overdue. That's why I was so disappointed when I heard Governor Christie's comments indicating he is considering joining other Republican governors across the country in refusing to expand access to Medicaid for the state's uninsured poor.

Immediate implementation

Now that the Supreme Court has unequivocally ruled the Affordable Care Act the law of the land, New Jersey should immediately begin implementing the Medicaid expansion, as well as move to create our state health care exchange.

You may be surprised to learn that New Jersey has already taken the commendable step of being one of only five states, and the only one with a Republican governor, to request a Medicaid waiver through the Affordable Care Act. This waiver increases Medicaid coverage for uninsured, childless adults.

New Jersey's waiver became effective in April 2011, and allows enrollment for childless adults who have incomes up to 23 percent of the federal poverty line in Medicaid. So far, 50,490 eligible residents have taken advantage of this opportunity.

It would be a mistake for our state to back away from our proactive efforts to expand Medicaid access. Another half million New Jerseyans will benefit if we fully implement this provision.

But this expansion is about more than just ensuring people have access to quality health insurance. It's about reducing costs for everyone in the system.

When uninsured individuals use emergency services, everyone else has to pay in the form of increased insurance premiums and taxpayer reimbursements to hospitals. This is not small potatoes; New Jersey hospitals spent approximately $1.35 billion on charity care last year alone, and New Jersey taxpayers reimbursed hospitals $337.5 million of that.

While some are troubled with the effect an expansion of Medicaid could have on our state's budget, we wrote the law precisely to assuage such concerns. The federal government will pay for the entire cost of the Medicaid expansion for the first three years of the program. After that, federal funding is gradually reduced to 90 percent, where it will remain.

All in all, the federal government could send more than $11 billion to New Jersey by 2019 to pay for this expansion. Considering New Jersey gets only 61 cents back for every dollar we send down to Washington, it would be a disservice to New Jersey taxpayers not to take full advantage of these federal funds.

But the Affordable Care Act is about more than just this one program. New Jersey should also move ahead with approving a state health exchange. This exchange will provide New Jerseyans with a comprehensive way to find affordable and quality health plans while encouraging competition and bringing down costs.

Our state could be eligible for hundreds of millions of dollars in additional federal grants to set up this exchange if legislation implementing one is signed.

Reject extremism

My colleague, Rep. Scott Garrett, recently wrote to all 50 governors, urging them not to create their state health care exchanges. Christie should reject this extremism. When he vetoed a bill earlier this year to create a state exchange, he said he wanted to wait for the Supreme Court to rule.

The Supreme Court has decided. Now New Jersey needs to move forward with implementing this historic legislation.

While refusing to implement the exchanges or Medicaid expansion might score the governor points with the most extreme elements of his party, it will be at the expense of the best interests of the people of New Jersey.

The Affordable Care Act will provide health insurance to the most vulnerable among us, reduce costs for all New Jerseysans and bring needed federal funding for our state.

To do anything less than fully implement this law would be the height of irresponsibility.


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