By Representative Fred Upton and Governor Bob McDonnell
Without repeal or delay, the full implementation of ObamaCare is now less than 15 months away. Yet citizens and policymakers face a mounting level of questions, fears and frustrations.
Unfortunately, the administration's continuing silence on its plans leaves patients, states and Congress with more anxiety than answers and taxpayers on the hook for it all.
In June, the Supreme Court held as unconstitutional ObamaCare's mandatory expansion of Medicaid. That decision brought some relief to states concerned about this unprecedented expansion of the program at a time when they are already struggling to sustain their current Medicaid rosters.
Yet with relief came more uncertainty regarding the administration's alternative plans to implement key components of the president's health care law.
In July, more than half of the nation's governors sent a letter to Health and Human Services Secretary Kathleen Sebelius requesting information from the department on its plans to implement the now-optional Medicaid expansions and health insurance exchanges nationwide.
Rather than collaborating with states on their important questions, the secretary left these serious and substantive questions generally unaddressed and unanswered.
In a follow-up letter to Sebelius, the governors expressed disappointment with the Obama administration's unwillingness to work together, noting, "With the challenging and detailed work ahead for our nation to address the issues of health care, the letter (from HHS) was wholly inadequate."
A similar letter requesting greater certainty from HHS was also sent by the National Association of Medicaid Directors -- a bipartisan group representing all 50 states. It also went unanswered.
Unfortunately, silence and lack of certainty are not just isolated to state requests. The department's tactic of dodging questions and delaying responses has also been applied to congressional oversight letters seeking greater clarity from this administration.
In August, the House Energy and Commerce Committee sent a letter to Sebelius pressing for a response to the states' urgent request for information, noting, "While it seems the Centers for Medicare and Medicaid Services intends to delay any major announcements until after November, states do not have the luxury of procrastination."
Dodges and delays are not prescriptions for improving health care; they don't help citizens and policymakers seeking to better understand ObamaCare's real impact and its true costs.
The administration may want to continue to play politics by hiding the ball until after November when it comes to these official information requests, but taxpayers deserve answers. The regulatory uncertainty has crippled states and health providers in their ability to plan.
These issues are neither simple nor inexpensive. According to the Congressional Budget Office, a nationwide expansion of Medicaid could cost more than $900 billion over the next decade, contributing to the $5 trillion in federal Medicaid spending over the same time period. Most shocking is that if ObamaCare is fully implemented, more than one in four Americans could become Medicaid enrollees and millions more could be forced into coverage through a federal or state exchange.
Americans are tired of Washington spending money it doesn't have and equally frustrated with a federal government so big it can't find its way out of the regulatory maze it created. They, and we, see the irony in this administration consistently touting its commitment to transparency.
In fact, Obama has said, "My administration is committed to creating an unprecedented level of openness in government. We will work together to ensure the public trust and establish a system of transparency, public participation and collaboration."
The silence coming from his administration over the last several months doesn't match that stated goal.
The American people and policymakers charged with implementing the law need more than gauzy promises and feel-good rhetoric. And they certainly deserve better than a stiff arm when it comes to clarifying informational requests. We need information.
The governors, Congress and health professionals are fulfilling their duties by attempting to gain clear answers to serious questions about a complicated public policy that will have a direct impact on the citizens. The administration needs to provide those answers. Detaining details in Washington for the next several months may serve political interests, but it's an indulgence policymakers and citizens cannot afford.
McDonnell is governor of Virginia and chairman of the Republican Governors Association. Upton, R-Mich., is chairman of the House Energy and Commerce Committee.