Stouffer: Governor considering executive order for health care program

In his weekly column, Sen. Bill Stouffer, R-Napton, discusses implementation of the federal health care program.

A new development has come to light in the federal health care debate, and it involves a potential executive order that would go against the will of the people and the Legislature.

Among the many elements of the president’s Affordable Care Act is one that provides funding for states in order to establish health insurance exchanges, which are designed to offer affordable health care choices for both individuals and businesses. Missouri is in line for anywhere between $13 million and $21 million to start its own exchange.

With this in mind, the Senate Interim Committee on Health Insurance Exchanges was formed to study the effectiveness of exchanges, and whether or not one is actually needed here. As they were meeting in Jefferson City in mid-September, word came that members of the Missouri Health Insurance Pool were gathering to enact the “Show-Me Health Insurance Exchange,” established by an executive order by the governor. It turns out that this was not the case. Swift actions taken by various lawmakers stopped this vote from happening.

Executive orders are used by governors and presidents to swiftly enact new laws without the consent of legislatures or the people.

States have until 2013 to either enact health insurance exchanges or face more federal government intervention, which is essentially putting Missouri between a rock and a hard place. Proponents of exchanges say these are necessary as the first steps toward getting coverage for more folks and driving down costs. However, opponents say exchanges would do the exact opposite, turning into a major unfunded mandate on the state, resting on the state’s shoulders in one year. By 2014, there is no more federal funding for the exchanges.

Unfortunately, there is not much to stop the governor from proceeding with an executive order to make this all possible. If this were to happen, it would mean no one in the general public or in the Legislature would have anything to say about how these health insurance exchanges are created, or allow any way to stop them from occurring. Our hands would be tied.

The whole purpose of the Senate interim committee is to study the need for an exchange. Committee members may find we would benefit from a health insurance exchange, or they may discover it would be a bad idea. It may be a good idea for Missouri to design the exchanges instead of the federal government doing it for us. Either way, can we justify one person signing an order, and undermining a legislative committee’s work, just in the hopes of getting more one-time federal money into the state?

There is not a lot of time before the Affordable care Act begins to take full effect. There are still a lot of unknowns about the proposal. We hear one day how broke we are, as a country. The next, we hear how billions of dollars will be spent on a plan fewer people support each day. We have to be extremely careful with how taxpayer money is spent, at every level. The Missouri Senate’s committee is helping to do this. I pray the governor will take this committee’s work into consideration before signing an executive order.