Obama lends support to states' health alternative

February 28, 2011

Burlington Free Press

WASHINGTON — In a concession over his divisive
health care overhaul, President Barack Obama
offered Monday to let unhappy states design
alternative plans as long as they fulfill the goals
of his landmark law.

Addressing the nation's governors, Obama also
challenged state chiefs who have sought to
balance their budgets through weakening unions
and curbing employees' benefits, telling them
that they should not demonize workers.

"I don't think it does anybody any good when
public employees are denigrated or vilified or
their rights are infringed upon. We need to
attract the best and the brightest to public
service," the president said.

About half the states are suing to overturn
Obama's health care law, targeting its unpopular
requirement that most Americans carry health
insurance or face fines from the IRS. Obama told
the governors that if any of them have better
ideas, they're welcome to propose it and see if it

First they would have to convince Washington
that their approach covers at least as many state
residents, provides equally affordable and
comprehensive benefits, and would not increase
the federal deficit.

"If your state can create a plan that can cover as
many people as affordably and comprehensively
as the Affordable Care Act does, without
increasing the deficit, you can implement that
plan and we'll work with you to do it," Obama
told the governors.

Obama's offer is not as sweeping as it may
sound at first. In fact, the law already allows
states to propose their own framework for
health care. But under the law, states cannot
offer their plans until 2017. The president said
Monday states could submit their ideas three
years earlier, in 2014.

Liberal-leaning states like Vermont would be
able to experiment with a coverage-for-all
approach similar to Medicare while Republican-
leaning states would be able to propose plans
that don't rely on a government mandate to buy
insurance. One alternative would be to
automatically enroll people in health coverage.

The idea to move up the date for state
experimentation did not start with Obama.
Democratic Sen. Ron Wyden of Oregon and M
assachusetts Republican Sen. Scott Brown have
already proposed it in legislation. But the
president gave it a prominent endorsement.

"I think that's a reasonable proposal, I support
it," Obama said Monday. "It will give you
flexibility more quickly, while still guaranteeing
the American people reform."

The health care law's big push to cover the
uninsured won't come for another three years.
Starting in 2014, many middle-class households
will be able to buy taxpayer-subsidized private
coverage through new state based insurance
markets. And more low-income people would be
signed up for Medicaid. The law will expand
coverage to more than 30 million now uninsured.

But Obama didn't just offer compromise to
Republican governors. He challenged state chiefs
over their treatment of unions.

Obama said all stakeholders must have a role in
discussions about state budgets and employees
should not lose rights as governors look to cut
spending. His comments come as Republican
governors in Wisconsin and Ohio back bills that
would end collective bargaining agreements for
public employees.

Obama said he understands the fiscal challenges
facing cash-strapped states and says everyone
should be prepared "to give something up."

"We're not going to attract the best teachers for
our kids, for example, if they make only a
fraction of what other professionals make,"
Obama said. "You're not going to convince the
bravest Americans to put their lives on the line
as police officers or fire fighters if you don't
properly reward their bravery."