Will Conservatives Reject Obamacare’s Rebates?

Will Conservatives Reject Obamacare’s Rebates?

WASHINGTON — Here’s a chance for all who think Obamacare is a socialist Big Government scheme to put their money where their ideology is: If you truly hate the Affordable Care Act, you must send back any of those rebate checks you receive from your insurance companies thanks to the new law.

This is just common sense. If you think free enterprise should be liberated from Washington’s interference, what right does Uncle Sam have to tell the insurers they owe you a better deal? Keeping those refunds will make you complicit with Leviathan.

And here’s a challenge to Mitt Romney. You are running a deceitful ad about waivers the Obama administration has yet to issue based on rules allowing governors to operate their welfare-to-work programs more effectively. Will you please stop talking about your devotion to states’ rights?

Up to now, you were the guy who said that wisdom on matters related to social programming (including health insurance) lies with state governments. Five governors, including two of your fellow Republicans, thought they had a better way to make welfare reform work. The Department of Health and Human Services responded by proposing to give states more latitude. Isn’t that what honoring the good judgment of state governments is all about?

Oh yes, and if Romney thinks Obama is gutting welfare reform, I anxiously await his criticism of Brian Sandoval of Nevada and Gary R. Herbert of Utah, GOP governors who requested waivers. If Romney means what he says, doesn’t he have to condemn those who asked Obama to do what Obama did?

Political commentary these days is obsessed with the triviality of this campaign. Most of it is rooted in the refusal of conservatives to be candid about the implications of how their beliefs and commitments would affect the choices they would have government make — and how these differ from the president’s.

In Romney’s case, this often requires him to invent an Obama who exists only in the imagination of his ad makers. So they take Obama’s statements, clip out relevant sentences, and run ads attacking some strung-together words that have a limited connection to what the president said. In the welfare ad, Romney lies outright.

But this is part of a larger pattern on the right, illustrated most tellingly by conservative rhetoric around the Affordable Care Act. In going after Obamacare, conservatives almost never talk about the specific provisions of the law. They try to drown it in anti-government rhetoric. “Help us defeat Obamacare,” Romney said after the Supreme Court declared the law constitutional. “Help us defeat the liberal agenda that makes government too big, too intrusive, and is killing jobs across this great country.”

Well, the new law does intrude directly in the insurance market. It requires that at least 85 percent of large-group premiums and 80 percent of small-group and individual premiums be spent directly on clinical services and improving the quality of health care. Imagine the radicalism: The government is telling insurance companies that they must spend most of the money they take in on actual health care for the people and businesses paying the premiums.

If the insurers spend below those levels, they have to refund the difference. According to calculations by the Department of Health and Human Services, 12.8 million Americans will get back $1.1 billion in rebates. That comes to an average rebate of $151 per household. In 12 states, the rebates will average $300 or more.

Here’s your chance, conservatives. Big bad government is forcing those nice insurance companies to give people a break. From what you say, you see this as socialism, a case of the heavy hand of Washington meddling with the right of contract. You cannot possibly keep this money. So stand up for those oppressed insurers and give them their rebates back!

As for the waivers on welfare, Romney’s position is dispiriting. Here’s a former governor whose Massachusetts health care plan — the one that resembles Obamacare — was made possible by federal waivers; who, like other governors, wanted flexibility to do welfare reform his way; and who has said he would roll back Obamacare through the waiver process he now assails. He’s turning away from what he claims to believe about state-level innovation for the sake of a cheap and misleading campaign point.

I’d also be curious to know if Romney got a rebate on his health insurance premiums courtesy of Obamacare, and if he plans to return it. But given his attitude toward disclosure, we’ll probably never find out.

E.J. Dionne’s email address is ejdionne@washpost.com.

Photo by Gage Skidmore

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