Captain Zero and the Health Care Exchanges

When we last saw Captain Zero, he was muddied and bloodied by his loss in the U.S. Supreme Court. The Affordable Care Act was – Gasp! – constitutional. Captain Zero’s efforts to defeat the Evil Federal Monster had failed again.

Captain Zero had fought the Evil Federal Monster and its Minions many times before. The Endangered Species Act and Cook Inlet Beluga Whales. The Environmental Protection Agency and Greenhouse Gases. The Department of the Interior and its moratorium on off-shore leases following the BP disaster in the Gulf of Mexico. The heroic Captain Zero has been tireless in fighting the Evil Federal Monster.

Completely futile, as it turns out, losing every time, but you have to admit he has been tireless.

But not this time. This time, he has invited the Evil Federal Monster into the governor’s mansion. He’s baked cookies and he’s serving the Monster tea.

The Affordable Care Act requires states to set up health care exchanges. These are intended to be one stop shops, managed by the states or a nonprofit selected by a state, to provide a single point for comparison shopping of health insurance plans. Alaska’s very high rate of uninsured citizens and comparatively few health insurance providers make this a big deal. A carefully designed health insurance exchange might attract more insurers to the Alaska market. More insurers might mean more competition, lower premiums, better coverages and less confusion. It would have involved some work and, yes, some expense, but it carried the potential to provide huge benefits to the Alaska public.

But Alaskans know what Captain Zero does when he fails to get his way: he packs up his marbles and goes home.

Even if it means letting the Evil Federal Monster design and implement Alaska’s health insurance exchange. Because that’s what is going to happen. Rather than develop a state-operated health insurance exchange, Captain Zero has decided to let the federal government do it. Because it might cost the state of Alaska money if the State were to do it and, you know, that would be an unfunded mandate. Oh, wait. Captain Zero already rejected the Federal funding to help set up the health care exchange.

The idea of a cost benefit analysis apparently has escaped Captain Zero, as he scooped up his marbles and ran home.

Captain Zero has surrendered Alaska’s ability to control its health care destiny. It’s a huge chunk of the Alaska economy. According to the University of Alaska Institute for Social and Economic Research,

Health-care spending for Alaskans reached about $7.5 billion in 2010. For comparison, that’s close to half the wellhead value of all the oil produced in Alaska that year. It’s also roughly equal to half the wages Alaskans collected in 2010. (Emphasis added.)

And health care spending is growing, both in amounts spent and as a percentage of the economy. ISER also found

The state’s health-care spending has been rising fast, tripling since 1990 and jumping 40% just between 2005 and 2010—and at current trends it could double by 2020, reaching more than $14 billion.

And Captain Zero’s justification for letting the Feds develop the health care exchanges is that it might cost a little money to set them up? Perhaps $6.7 million. Against a $7.5 billion a year item that’s growing at 8-9% a year? It doesn’t wash, Governor. It doesn’t even pass the red face test. This is about posturing for the teabaggers. This is about sulking because the Affordable Care Act is constitutional. You’ll fight a ridiculous, stupid and losing lawsuit over Beluga Whales to limit federal powers. But you’ll abdicate to the Feds in the multi-billion dollar health care struggles.

To paraphrase Garry Trudeau, “How long does it take to betray everything you’ve ever stood for, Governor?” WC thinks the paperwork alone must be incredible.

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