Are there many ways that a state could shield businesses in their state from an onerous, job killing tax penalty? In most cases - no. But in the case of ObamaCare the answer is a definitive "yes!!!"

ObamaCare seeks to have states set up insurance exchanges or government controlled "markets" whereby federal subsidies are dolled out so that people can buy heavily regulated, government approved health insurance. According to this article from The Wall Street Journal, if a state establishes an exchange, ObamaCare allows the subsidies to be given out (see Section 1311). If a state refuses to set up an exchange, the federal government will do so but ObamaCare does not permit any subsidies for people who access the federal exchanges (see Section 1321). 

So, a state that takes a pass on establishing an exchange (as many states have chosen to do) is effectively telling the feds, "we aren't going to spend state tax dollars to do your dirty work - have at it." But here is where a state that decides to take a pass can really benefit that state's economy. Under ObamaCare, if someone receives an exchange subsidy, their employer is subject to a penalty under ObamaCare but if no employees receive a subsidy employers are not subject to the penalty. Get it? The bottom line is that states can protect job creators from onerous federal taxes if they refuse to create and set up an ObamaCare insurance exchange. That is a significant incentive for states to protect their economy and jobs. The alternative is to create an exchange, letting the penalty kick in, resulting in fewer businesses and fewer jobs which will create a double-whammy for state taxpayers. Taxpayer will have to foot the bill to deal with the further strain on a state's social safety net resulting from higher unemployment and would end up footing the bill to finance a system to hand out federal bennies.  A bad deal all around for states, employers, employees and taxpayers.

Read more about this here.

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Senator Orrin Hatch (R-UT), ranking member of the Senate Finance Committeee, weighed in on a report from the National Governor's Association about the burden that Medicaid, and its expansion under ObamaCare, imposes on the states. From his November 29, 2011 Press Release:

"[T]he National Governors Association’s (NGA) Fiscal Survey of the States demonstrates why repealing the Medicaid Maintenance of Effort requirement, first imposed in the stimulus package and again in the $2.6 trillion health spending law, and modernizing the Medicaid programs is essential to allowing states effectively manage their Medicaid programs." 

"The report released today found that state budget deficits cumulatively amount to at least $365 billion over the next five years and that Medicaid enrollment is up by 17.7 percent with this joint federal-state program making up the largest portion of state budgets. The NGA also found, "spending on Medicaid is expected to consume an increasing share of state budgets and grow much more rapidly than state revenue growth, resulting in slow or no growth in education, transportation or public safety.

Reports about Medicaid can be found: here (from the RGA) and here (from Members of Congress). 

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Jonathan H. Adler and Michael F. Cannon write in today's Wall Street Journal about one of ObamaCare's fatal flaws (a flaw that, thankfully, undermines much of the law). As AHEC as previously explained, ObamaCare requires states to set up insurance exchanges to regulate the sale of health insurance (and which will likely lead to a one-size-fits-all insurance policy where consumers have fewer choices and, with fewer choices, consumers will see more expensive insurance). The ObamaCare subsidies will be given to qualified people who obtain insurance through the government exchanges.  

Here is the flaw in ObamaCare. Individuals who buy insurance outside of the exchange will not be eligible for the subsidies.  So what happens if you were to price shop and find a more affordable policy that is not offered through an exchange? You pay 100% of the cost yourself - no subsidy. What happens if your state does not create an exchange and the federal government sets one up in your state? According to Adler and Cannon - the same thing. No one who buys insurance through a federal exchange is eligible for the subsidy. This is just another reason that ObamaCare was poorly conceived, poorly designed, poorly written and is and will be poorly implemented. Congress should scrap the law and start over - something this badly broken simply can not be fixed.

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AHEC has recently completed an extensive fiscal and policy review of the Health Care Compact (HCC or compact), legislation that has been introduced in several states. The conclusion of our fiscal review of the HCC is that the compact's funding formula is fatally flawed and that it will shift $3 trillion of healthcare liabilities from the federal government onto the backs of the states. Our report even provides a break down of the fiscal shortfall that will be created in each state if the compact were to be widely adopted.

Ironically, the group pushing the HCC has confirmed AHEC's $3 trillion figure but has failed to inform state legislators of how this will impact their state's budget. It would be the height of fiscal irresponsibility for a state to pass the compact given the obvious flaws in the funding formula, particularly if a state does not have a plan in place to ensure that the state's most vulnerable citizens will not receive proper health care. Yet some states (Texas, Oklahoma, Georgia and Missouri) have done just that.

READ AHEC'S FULL REPORT ON THE HCC HERE.

AHEC has previously discussed the myriad of problems with the Health Care Compact.  You can read much of AHEC's previous work on the HCC in the following places:

1. AHEC's Blog: The Connection of the HCC to Efforts to Enact Socialized Medicine
2. AHEC's Blog: The HCC will lead to Taxpayer Funding of Abortions and Free HealthCare for Illegal Aliens
3. A Line of Sight: A Conservative Assessment of the HCC

If you are concerned about the implications of the Health Care Compact, please call your state legislators (especially in Tennessee, Wisconsin, Florida, Ohio, Pennsylvania and Michigan and tell them to oppose the Health Care Compact).

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The Galen Institute has put together a very thoughtful list of healthcare reform ideas (and ideas to avoid) for the so-called "Congressional Super Committee" that is charged with producing nearly $1.5 trillion in budgetary savings. You can read the full list of reforms here. 

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Over the July 4th Holiday Weekend, AHEC's staff gave a presentation in Columbus, Ohio on ObamaCare's impact on Ohio at the "We the People" convention.  The full presentation can be found on AHEC's Analysis page.

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Through a "glitch" ObamaCare will make up to 3 million early retirees eligible for Medicaid.  ObamaCare excludes social security income so that retirees making $64,000 a year IN RETIREMENT can still get healthcare courtesy of the rest of America who are working hard but may be struggling to get by.

More on the insanity of ObamaCare can be found here and here.

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Reform+Medicaid has two very interesting posts about the impact ObamaCare will have on Texas and Oklahoma's Medicaid programs and the strain the law will have on the states' budgets.

Pointing to a study by the Texas Public Policy Foundation, the blog notes: "Texas Medicaid expenditures will increase by between $2.5 to 3 billion per year over the next decade if Obama’s law is implemented in its current form, primarily because people who are currently eligible but not enrolled will be forced into the program due to the individual mandate to obtain health insurance."

In relation to Oklahoma, the blog refers to an analysis by the Oklahoma Counsel of Public Affairs.  A separate post quotes the key finding of the study: "Our research projects the expansion will increase Medicaid enrollment to 36 percent of the population by 2023 and will add an additional $11.4 billion to state program expenditures during the first 10 years (2014-23) after the law goes into effect."

This information is not limited to Oklahoma and Texas.  ObamaCare will destroy the state budgets in states across the country.

Be sure to follow AHEC on Twitter @TheAHEC and at Facebook.com/TheAHEC.  

Be sure to follow AHEC on Twitter @TheAHEC and at Facebook.com/TheAHEC.