South Carolina’s “Health Planning Committee” Doesn’t Do Much Planning

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The  South Carolina Health Planning Committee, established by the governor,  is now in its fifth month. Its mission is (1) to recommend either that  the state set up a health exchange (a government-run “marketplace” for  health insurance, in accordance with the new federal health care law) or  refrain from doing so. If the Committee decides to recommend against an  exchange, it’s then tasked with (2) proposing alternative reforms that  would improve South Carolina’s health care market.

What’s the Committee doing? Over the last few months (check out our video coverage),  we’ve watched a roomful of policymakers and health care officials  struggle to come to grips with the bureaucratic nightmare known as the  Patient Protection and Affordable Care Act. Listening to the governor’s  committee attempt to make sense of it is a little like watching Sisyphus roll his boulder up that hill in Hades. Each time the committee members  believe they’ve reached consensus on what the law actually means, a new  expert or lawyer or consultant contradicts it.

Even if South  Carolina’s Committee could come to some kind of agreement on how to  interpret the new law, federal regulators can’t seem to make up their  minds on how to implement their own bill: the U.S. Department of Health  and Human Services has already added about 150 pages of regulations to  the already massive bill, with many more regulations supposedly  forthcoming. The result? Endless confusion on both the state and federal  level about a largely unfinished piece of legislation pushed into law  way too fast to be workable.

What’s the Committee not doing? The  Committee is nowhere near deciding whether to recommend setting up an  exchange; its members are barely able to make sense of the law as it’s  written. There has been very little discussion of alternative ways to reforming the health care market. That part of the governor’s Executive Order has so far been ignored.

►   In fact, when one committee member asked why South Carolinians  shouldn’t have more control over their health insurance purchasing  decisions, a Blue Cross/Blue Shield official asked sarcastically, “Why not eliminate all the laws in a state that make it more restrictive than any other state?”

Clearly,  then, recommending the removal of government barriers as a way of  creating a more affordable health insurance market isn’t on the  Committee’s agenda.

A natural response to this intrusion by the  federal government would be to refuse to set up any kind of state  exchange: in the absence of any clear plan or expectations, it’s unclear  why the Committee wouldn’t consider abandoning this confusing and  unfunded mandate.

Instead, they’ve focused on the “solution” of  implementing a what they call a “free-market” or “minimal” version of a  state exchange. Sadly, no vision of what such an exchange would look  like has been forthcoming in the committee meetings we’ve attended.  Unfortunately for the Committee, the concept of a “free-market” state  health exchange is an oxymoron and a myth, as we’ll outline in the weeks  to come.

Copyright © 2011 South Carolina Policy Council

This material should not be construed as an attempt to aid or hinder the passage of any legislation.

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