Its maddening. Its curious. Its ironic. And it is, to some degree, a little funny.
The Republican leaders of a Southern state all about anti-big government rhetoric, full of resentment toward a Democratic president who dared to try to reform a flawed health-care system and expand accessibility, preoccupied with what they see as continuing over-regulation from Washington pass up a chance to control part of that reform at the state level.
And so that control now goes to the federal government!
The scenario applies to North Carolina and other states that waited too long to act on a requirement under federal health care reform that states establish an online health care marketplace. The idea is to give uninsured individuals and small businesses a place to shop for affordable health insurance once reform kicks in full-blast in 2014.
Republicans in the General Assembly made their feelings known when they passed a bill last year as one of their first acts on taking power from Democrats that would have prohibited government-mandated insurance coverage. It was a mean-spirited waste of time, and Gov. Beverly Perdue rightly vetoed it.
Still, there was some movement toward setting up an exchange, as the marketplaces are called, but nothing passed both the state House and Senate. Part of the reason was that GOP lawmakers in North Carolina were awaiting the U.S. Supreme Courts review of the presidents Affordable Care Act. To their surprise, no doubt, the act passed muster with a narrow high court majority, including Chief Justice John Roberts Jr.
Thanks to delays, the anti-government crowd on Jones Street now has surrendered control of any health care exchange to the Washington bureaucrats. And this happened even though a respected group of more than 250 experts, under the direction of the N.C. Institute of Medicine, came up with some perfectly clear recommendations on how the state could go about setting up an exchange.
If reform remains in place along with an exchange, the rate of uninsured adults in North Carolina who are not elderly is projected to drop from 18 percent to 8 percent in 2014. And reform already has resulted in more sick children being eligible for insurance, parents being able to hold their kids on their insurance policies into their mid-20s and more preventative care.
The Obama plan, in addition, is designed in a way that wont inflate costs of coverage, although there is work to be done in addressing the thorny problem of cutting the costs of care itself.
Not invented here
The core of the opposition to Obamacare seems to be what it always has been: resentment of a Democratic president who dared to take on an issue of significance to millions of Americans simply because he is a moderate Democrat.
The presidents reform remains tied to the market for health insurance provided by private companies. Reform opponents criticize what they mistakenly describe as a government takeover of the health care system while hoping Americans forget that there already is a government-run health care system, called Medicare, that serves millions of people and saves them from ruinous expenses.
But those issues aside, the lackadaisical attitude of Republican lawmakers toward moving forward on a North Carolina health care exchange now has brought in the federal government, like it or not. For though they no doubt dont like to think about it, the most ardent opponents of reform must recognize that a conservative Supreme Court has pronounced the Obama reforms largely constitutional.
Its too bad that GOP leaders in the General Assembly have, with their inaction, handed off the responsibility for a health care exchange in the state to that which they seem to despise most, the federal government.