CPAC 2014 - Healthcare after ObamaCare: A Practical Guide, Part 2

Ladies and gentlemen, please welcome Dan Garza, Executive Director of Libre Initiative. To the people of Venezuela and Ukraine fighting for liberty, we are with you. Para mi gente, mi pueblo en Venezuela, estamos contigo, los que están luchando por la libertad. When it comes to Obamacare, there is an ever-widening gap between what was promised and what the law is actually delivering in real results. President Barack Obama is constantly telling the American public what he intends the law to deliver, but is having to answer questions about a growing list of broken promises, the consequences the ACA gives us on a daily basis, and the many delays he has been forced to announce on a monthly basis now. In full damage control mode, Democrat congressmen are now busy putting out campaign commercials claiming that they are the first to call for fixes to Obamacare's many problems. You might be able to throw more taxpayer money at fixing the horrendous website, but how do you fix a system that is mandated by government, run by an army of bureaucrats, and riddled with price controls? When it comes to something as critical as our personal health care, statism can't be fixed. It has to be replaced with market-based solutions. On today's panel, we will discuss what conservatives are doing to cope with Obamacare moving forward and what they are offering as alternatives. Market-based solutions that would come after the system eventually collapses. Skyrocketing prices, doctors leaving the system in droves, millions being kicked out of their individual and employee-based plans, and all the while, participating states going bankrupt. For this discussion, I want to introduce our panel. The first is Evan Feinberg. He fought for limited government and traditional values while working as a senior aide for both Senator Rand Paul and Senator Tom Coburn with the Heritage Foundation. He now leads the millennial-focused organization Generation Opportunity, working to free the future. The Honorable Scott Pruitt is the Attorney General of Oklahoma. Scott established Oklahoma's first federalism unit in the office of the Solicitor General to combat unwarranted regulation and systematic overreach by the federal government. Scott is a national leader in the cause to restore the proper balance of power between the states and federal government. He filed the first lawsuit challenging the implementation of the Affordable Care Act. Shona Holmes is a self-employed 50-year-old mother and grandmother from Ontario, Canada. She fled to the United States for life-saving surgery after her government-run health care failed to provide the care she desperately needed. She has become a passionate patient advocate who feels strongly about the need to caution Americans about the negatives of government-run health care. And the Honorable Dr. Mark Green. He is a state senator from Tennessee's 22nd District. He serves as the vice chair of the Commerce Committee. Mark was selected as the Tennessee Journal's Rookie of the Year, appointed co-chair of the Physicians' Legislators for 16 states, and was recognized as one of GOPAC's top 21 emerging leaders. Dr. Green is a president and CEO of AlignMD, an emergency department staffing company with businesses in five southern states. Mark was assigned to the 160th Special Ops Aviation Regiment, where his most memorable mission was the capture of Saddam Hussein. During this time, Mark was selected as the Army Aviation Association Flight Surgeon of the Year. Let's welcome our panelists. Evan, I want to talk first about the promises made, promises broken. One of the promises was universal coverage. Candidate Obama promised on June 23, 2007, I will sign a universal health care bill into law by the end of my first term as the president that will cover every American. A pair of surveys released on Thursday suggest that just one in ten uninsured people who qualify for private health plans through the new marketplace have signed up for one. That's one in ten. Of people who are uninsured and do not intend to get a health plan through the marketplaces, the biggest factor is that they believe they could not afford one. Will this law cover every American, and what impact is Obamacare having on the young? Well, thanks so much, Daniel. Of course it won't cover every American. It's a terrible scheme that tries to use my generation to pay for an older, sicker population's health care. So it was fatally flawed from the start. But young Americans responded to those promises and were very favorable about Obamacare early on. It had an over 60% approval rating among my generation, 18 through 29-year-olds. It's now less than 40% of my generation that supports Obamacare. Over 60% oppose it. They're actually the least supportive generation of Obamacare of any age cohort. They found out that the promises weren't kept in the actual policy, that we're being forced to pay as much as three times more for our health care for the reason of paying for other people's health care. There's a reason why they keep trying to give us these really pathetic marketing pitches, trying to sign us up for this terrible deal that offers us nothing and really offers the country nothing. So there's a reason why young Americans are opting out of Obamacare, as we've encouraged them to do, and choosing to take a better deal for themselves outside the Obamacare scheme. Speaking of marketing, you were responsible for one of the most successful marketing strategies with Uncle Sam. Can you talk to us a little bit about that? Absolutely. We did a little ad campaign around Creepy Uncle Sam. And Creepy Uncle Sam represents a really patriotic image being really perverted into something that government was never meant to be, something that controls our lives and injects the government into the doctor-patient relationship. And so millions of young people saw on YouTube these Creepy Uncle Sam ads and thankfully many of them responded by realizing they could opt out of Obamacare and they're choosing not to sign up. Congratulations on that campaign. Thank you, thank you. Another promise, General, Another promise, General, was that no new taxes on the middle class. Candidate Barack Obama promised on September 12, 2008, I can make a firm pledge under my plan, no family making less than $250,000 a year will see any form of tax increase. Not your income tax. Not your payroll tax. Not your capital gains taxes. Not any of your taxes. General Pruitt, you are suing the administration to make sure the IRS doesn't come after your state. Talk to us about your efforts to protect Oklahoma and if this promise was held for the rest of America. You know, Dan, I know it's going to shock you and I'm sure shock many in this room, but the IRS is not complying with the law. And the Affordable Care Act, when it was passed, was very clear. The states had a decision to make on whether to set up a state health care exchange. The Senator from Tennessee and various legislators from your states made informed decisions about whether to set up a state health care exchange. Well, because 34 states said no, and because the subsidies were going to be issued through the state health care exchange, which then would not allow the penalties to be assessed if states didn't set them up, the IRS came in after the fact and said we'll fix that. We'll pass a rule, and they did so in May of 2012, and said we'll change the law. We're going to issue the subsidies in all 50 states and therefore assess the penalties in all 50 states. There's just one problem with that. That's not what the law says. And so you have this attitude in Washington, D.C. these days, with many agencies, but particularly the IRS, that they feel like their responsibility, they feel like it's their role to improve upon a statute, to change a statute, to enforce it in a way that is different than the way Congress passed it. And after all, that's the reason the President can say, I've got a pen and I've got a phone. It's the executive branch's responsibility to enforce the laws as they've been passed by Congress. And Oklahoma and 33 other states in the country made a decision to say we're not going to have a state health care exchange. That decision should be honored, it should be respected, it should be enforced. And because the IRS has done the opposite of that, Oklahoma is leading the charge to hold them accountable. If we're successful in Oklahoma in winning our lawsuit, and we hope to have a decision by the end, maybe, of the second quarter going into the third quarter, but if we're successful, 33 other states across the country could then say, because they have not set up a state health care exchange, the IRS cannot enforce the penalties in those states, which means that the primary enforcement mechanism against employers, the $2,000 per employee tax penalty, goes away in 34 states. The $700 billion of subsidies that are under the law goes away in 34 states. It is the most consequential case in the country. It will, I think, perhaps cause Congress to have to revisit the law. It is the last, best hope to see the Affordable Care Act go away. And so we're glad to be a part of it. Terrific. And what are the chances of success? I'm sorry? What are the chances of success? Well, you know, one of those famous philosophers, Yogi Berra, once said that predictions are pretty tough, particularly about the future. So I'm hopeful. We're right on the law. We believe we've got a court and a judge in Oklahoma that's going to get the law right. We're going to make sure that we press this and hold the IRS accountable. So we hope for good things. Terrific. Another promise, Senator Green, annual premium savings of $2,500. Candidate Obama promised on June 5, 2008, we'll lower premiums by up to $2,500 for a typical family per year. We'll do it by the end of my first term. That's what he said. Senator Green, how did this pan out and what can be done to get back to reversing the cost curve? Well, I think the first thing we need to do if we're going to try to fix Obamacare is elect a new president. That's probably the best thing we can do. But if we want to get back to those savings, we've really got to reinsert market forces into health care. There are some great companies out there with innovative ideas. Two come to mind. And by the way, I don't have stock in either of these companies, MetaBid and MDSave. What they're doing is essentially becoming the price line of health care. So you go to your physician. Your physician says you need an MRI on your knee. You go online to this company or these websites, and you essentially shop for the cheapest MRI that meets the needs of your physician's request or prescription. These are innovative ways that will reinsert the free market and drive down costs in health care. And we've got to do that because we physicians, we don't set these deductibles for patients. You know, the insurance companies do, and they're very high. The deductibles that are coming off the exchange, something like this, something free market-based will make these high deductibles more palatable and drive down costs. And if we don't do that, we're not going to be successful. There are tons of other ideas out there from telemedicine to other business opportunities that are helping drive down the cost. But that's the only way to fix the issue right now. Shona, one last promise that I want to speak to is that it's the most famous one. You can keep your plan if you like it. On June 15, 2009, President Obama promised if you like your health care plan, you'll be able to keep your health care plan, period. No one will take it away no matter what. This promise was made in various forms over three dozen times. How did this promise go so wrong, and will we ever be able to have true market choices and pick plans suitable to our individual needs? And also talk to me a little bit about your experience with the Canadian health care system and the caution for America. The sad thing is, is when I heard those promises, I, like many people, knew that it just was not possible. And I think myself and a lot of other people spoke out and said, you know, you have to really, really be cautious because this is not possible for him to be able to honour that promise that he made. And I think the next thing that is so important for people to focus on at this point is the other promises that he is making now. Those sorts of things that you are never going to have the Canadian system, that this is not going that direction, that this is very different. Yet you will hear a lot of people throw around the term single payer, which is exactly the Canadian system. And the other thing, the next promise that they're kind of leaning on at this point is that you will continue to have these choices. And this is where I'm here to say that you absolutely will not have choices. And I had to come over to the United States just to get diagnostic imaging done, just to see specialists. And then I returned to Canada to try and get treatment and I was unable to do it and had to return to the United States. And I was one of these people that actually thought, I'm actually embarrassed to admit it, but I thought that the American system was a horrible system until I was forced into trying it. And being a patient on two sides of the border, I can tell you that the minute you hand over any of your power to the government and let them get in between you and your doctor, it will be something that you will regret. Evan, is this something that the youth are resisting government control? That you see that this is really, I think, sort of the libertarian streak of this new millennial generation? Absolutely. So we ran a campaign, optout.org, to encourage young Americans not to sign up for Obamacare. Because we found two pervasive myths among young people before the law really started to be implemented. And one was that they were going to get universal health care, the government was just going to provide it to everyone, they could just show up to the doctor and it would be free. Little did they know they were going to get these massive bills for very little choices and very little health care. So we wanted to debunk that myth, but also debunk the myth that they really had to sign up. We would love for the penalties to go away and we would love for legislation to be moved forward that would remove the individual mandate penalty. But there are also lots of options outside of the Obamacare scheme that young Americans can take advantage of, even still. Now, unfortunately, there are fewer of those options because Obamacare is kicking them off their plans and putting a lot of those plans out of business. There are still some options. So in the short term, we've really found a lot of success in taking that message to young people and then really pushing back against Obamacare. But I think it's going to be part of a long-term fight. Right now, there's really a war on youth going on in America where politicians are really throwing the next generation under the bus. They're putting their next election before the next generation of Americans. And as long as that war on youth continues, our country is going to go bankrupt and young Americans are going to continue to have no economic opportunity. So I think the libertarian streak you see among young Americans today, the limited government streak among younger Americans, is because they've seen how big government has not helped to improve their lives or the lives of their peers. And soon enough, enough of us are going to push back and say, we want an America of freedom so that we can be the solutions to this country's problems. And Obamacare is clearly not that kind of policy that's going to create opportunity for my generation. So, Barack Obama has been also delaying big portions and components of the law. And I don't know why he's keeping this awesomeness from me. There are various legislative remedies moving through Congress meant to aid in addressing this issue. A bill allowing the House or the Senate to authorize legal action against moves by the administration to neglect the law. A major to require federal officials to give an explanation when laws are not enforced. Of course, born from the many arbitrary delays by President Obama. I sort of want to throw it out as a general question. And maybe, Senator, maybe you can start off on this issue. Do these provisions or these legislative efforts to remedy the situation have any merit and do they stand a chance? Well, the frustrations that I have as a businessman, I'm also not only a Tennessee State Senator, but I run a health care company, is with these rules of the pen that President Obama is doing, allowing certain companies to delay the mandate further. It's sort of picking and choosing. The most recent one said that companies of a certain size could. If you're not of that size, it's suddenly a competitive disadvantage to you. So they're picking who can opt out and who can't. That shouldn't happen. So I'm completely for Congress taking action to keep the president from usurping their powers to make the laws of the land. And as the attorney general said, it's his job to enforce those laws. So I'm all for them, you know, holding him to his job and not allowing him to do their job. Shona, do you think that these delays are because they're finding out that this is really a bad law with bad effects and bad results, like they found out in Canada? Well, I think that's what they're saying. They're saying if everybody relaxes, in four or five years, everything's going to calm down and you're really going to love what they've given you. Well, Canada has sort of 40, 45 years later, when we've already tried this, our system's imploding. And we're trying to fight our hardest to go the other way. And I'm actually a constitutional challenger in my province in order to fight just for the right to purchase private health insurance, because I'm not allowed to have it. I'm not allowed to use my own funds in any way to take care of myself and my family. However, I can get an MRI tomorrow at the vet of my choice for my dog, but I cannot for one of my children. And that is where I think that we really have to focus on, is that things aren't going to get better in four or five years. It's just going to be too late in four or five years. If I could, a quick expansion on that. I run a health care company and we have emergency departments all over the southeast. We actually have a hospital we provide coverage for where there's a Canadian company. And the CEO of that company recently flew from Canada to our town to get his health care in our emergency department. So that tells you the single-payer system is not where we want to go. General, is this entirely political, out of pure political self-interest? Is it CYA? What's going on here? On the changes and the delays, I think that's a large part of it. But I think that as bad as the Affordable Care Act is, and as much as we all hope that it's repealed, there's something more fundamental with your question, Dan, in my estimation. And the senator said that he owns a physician's practice. He's in the health care business. Think about this for a second. This law was passed in 2010. Insurance companies, hospitals, doctors, consumers, people across the country have been doing what since 2010? Planning, trying to do what rule of law is supposed to encourage, and that's what? Conform your conduct to what the law says. And so businesses are making decisions on how to deploy capital, who they hire, how are we going to comply with the law. For the president to come in unilaterally and consistently and say, well, I know the law says, but I'm going to change that. That causes things to be so disruptive in the health care industry that we don't know what to do. Doctors don't know what to do. Hospitals don't know what to do. And ultimately, that's why rule of law is so important. Rule of law is important because it allows us to have confidence in something larger than the leader. There's a phrase called Lex Rex. The law is bigger than the king. This president doesn't get that. He believes that he's above the law. These are not opinions that we're offering about whether he's been unfaithful in the execution of his duties or whether he's violated law. The Congressional Research Service has documented innumerable times where the president has unilaterally changed the law or repealed it. That should cause all of us tremendous concern, not just because we care about health care, not just because the Affordable Care Act is bad. We should care about that because of rule of law and fundamental notions of how we do business in this country that are different than the rest of the world. And we've got to start speaking to that because Democrats and Republicans ought to care about that. They ought to care about an executive branch that is filling the role of the legislature. They ought to care about a regulatory arm that simply goes out and does whatever they want, irrespective of what Congress has said in the statute. That causes all of us to be concerned. Just to follow on, I think to bring this into the hearts and minds of young Americans, Kathleen Sebelius went on The Daily Show, and Jon Stewart really pushed her, on how come young Americans who want relief from the individual mandate don't get the same benefit that businesses who are being given this reprieve from the penalties under Obamacare. And she said, oh, they absolutely can. They can just opt out and pay the penalty. We think that's what they should do. But it really brought home when Jon Stewart is just going after the administration night after night, why are you not implementing this law fairly and equally to all Americans? And I think that a rule of law argument can really be taken to every generation of Americans, people that are politically active, those that are not. Young Americans realize that this law is not benefiting them. It's not fair. It's not providing them anything of value. And so I think that's one of the reasons why you're seeing the negatives of this law just go up so dramatically. Once they start feeling the effects of Obamacare, everybody hates it. Because really what it's about at the end of the day, it's the administration picking winners and losers. They do that with the EPA in elevating renewables at the expense of fossil fuels. They're doing it in the health care context. You want a waiver, come and ask us to give it to you, and it empowers them in that process. So it's exactly what's wrong with our federal government today. Picking winners and losers within the context of a statute in the way that they are sends a terrible message to the rest of the world and to this country that we don't live under rule of law anymore. There's probably even a bigger, I mean if you take the satellite view, a bigger issue with this. Our constitution grants, the states have federalism, the powers of the state. That was an intended part of our constitution. What we have now is a situation where the Congress taxes us, takes the revenue to the federal government, and then if we comply with the program, we get a little bit of money back. Whether it's road dollars or health care dollars or education dollars. It's an undoing, or I should say, an end around to federalism. And that's probably an even bigger problem that concerns me. What are some of the problems that we see in the horizon that maybe we haven't anticipated yet that will result from the implementation of the employer mandate, for example? Anyone? Well, youth unemployment right now effectively is 16%. Young Americans are out of work. A third of young Americans under the age of 34 have been forced to move back in with their parents. The provisions of Obamacare are really crushing employers. They're making it really difficult for them to hire new employees. There's an entire generation of Americans who have never seen an American prosperity where they graduate from school, they've got lots of skills, they're able to get a job. It's truly unfortunate we've got these huge student loan bills. Obamacare is making that job market even worse. So if it's not enough that they're ruining our health care and making us pay three times as much for worse health care, they're also making it impossible for us to pay off our student loans and get our foot in the door into living the American dream. So that's the big problem on the horizon. Three times as much? Three times as much. Premiums for young Americans across the country are going up by at least three times to buy similar policies with huge deductibles that are still going to cost us way more out of pocket. There have been zero promises from Obamacare that have come true to make my health care any better. And that's what my generation has felt from this law, and that's why they're so negative about its prospects. Well, as you know, the Hispanic community is very young as well. We're 27 years of age median, average age, while the rest of the country is 12 years older than we are on an average. A survey by Forbes says that we will be paying 42% higher in one year on premiums as a result of Obamacare if you're 27 years of age. In a state like New Mexico, it's going to be 142%. So I feel your pain. Absolutely. And this is about insurance. This isn't about access to care. And that's where you're looking at the Canadian system is their lack of access. And, Dan, if I could add to that just real quickly. You bet. You know, we kind of yield in this debate that what took place in 2010 was about health care. It wasn't. It was about health insurance. And just because you cover more people, just because you cover the quote-unquote uninsured, it doesn't ensure that they have access to a physician. You know, for years and years and years, states have expanded Medicaid eligibility. Oklahoma has done it. Tennessee did it with TennCare several years ago. It went bankrupt. Not your fault, Senator. But that Medicaid expansion in Oklahoma, we covered children up to 200% of federal poverty. Those kids could not access a doctor in Tulsa, Oklahoma, because only two physicians took the reimbursement rate under Medicaid. So though the politicians could say, look what we did, we covered more kids, they didn't get access to care. We've got to switch the debate to focus on health care and how we provide and empower families to make those decisions as opposed to the government. Less quality of care, less choices, and higher and higher costs. Yeah, things are not panning out. Let's give a round of applause to our panelists. Thank you so much and enjoy the rest of the conference. Thank you.