A Kentucky senator talks Obamacare repeal

Rand Paul, Kentucky’s junior senator, recently explained his stance on the Senate’s healthcare bill. While acknowledging that he is part of a “team” in the Republican party, Paul stands on principles rather than blindly submitting to the party. Paul’s convictions led him to stand against the Senate’s Obamacare “repeal” bill. Paul explains that rather than repealing Obamacare, it keeps:

  • “the majority of Obamacare taxes,”
  • 10 out of 12 “major Obamacare regulations,”
  • “unsustainable expansion of Medicaid,”
  • insurance subsidies using taxpayer money, and
  • a “$200 billion bailout” of insurance companies.

This particular legislation is failing in the Senate, leaving an opening for real change. Actually repealing the Affordable Care Act would result in benefits not only for the nation in general but for Kentucky in particular.

The Bluegrass Institute on Kentucky Tonight—Healthcare

KyresizedBluegrass Institute president and CEO Jim Waters joined a panel on KET’s Kentucky Tonight this week to discuss the Affordable Care Act — often referred to as Obamacare — and it’s proposed replacement, the American Health Care Act (AHCA), which the U.S. House of Representatives recently passed by a thin 217-213 margin. The U.S. Senate has yet to act on the bill.

Waters, who previously called the AHCA “a RINO bill” — repeal in name only — noted the bill is not a full-scale repeal and replacement of Obamacare, but rather a tweaking of a few of its provisions.

He called it “Santa Claus politics,” keeping “a lot of the goodies in there, in terms of the subsidies and the handouts.”

Overall, he warns the bill “keeps many of the things the Obamacare plan had.”

One positive aspect of the bill, he said, is its allowance for states to apply for federal waivers, which will bring at least some of “the management and administration of healthcare dollars … back to the states,” which are better able to determine the needs of their own citizens than Washington’s huge federal bureaucracy.

Waters also took aim once again with Obamacare’s expanded Medicaid approach, which has greatly increased Kentuckians’ dependency on a government program for their health-care coverage.

“Medicaid was never intended to provide healthcare for one out of three Kentuckians,” Waters said, reiterating that the size of Medicaid needs to be shrunk so that the program can be put back on a sustainable path, while implementing more innovative ideas on providing health care for lower-income Americans and Kentuckians.

Others appearing on the program included Lexington Dr. Cameron Schaeffer, a pediatric urologist in Lexington, Dr. Barbara Casper, who teaches at the University of Louisville and Dustin Pugel from the Kentucky Center for Economic Policy.

“I’ve had a problem with Obamacare not only as a doctor but as an American” because it contravenes the American values of individualism, freedom and property rights, Schaeffer said.

One of the ways to mitigate the effects of increased numbers of sick and elderly beneficiaries is to share risk by incorporating younger, healthier people. However, Obamacare has discouraged the potential involvement of younger enrollees “by pooling young people into policies that are mandated to cover problems that old people get, and they can’t afford it,” he said.

The federal mandate for extensive coverage raises prices, making insurance “untenable” for young people, he said.

Watch the full program here.

Amy Searl is working with The Bluegrass Institute through the Koch Internship Program.

Bluegrass Beacon: Control costs, make health care great again

BluegrassBeaconLogoThe latest RINO to lose is the Repeal In Name Only health-care bill – also known officially as the American Health Care Act (AHCA) – meant to replace the Affordable Care Act (ACA).

To paraphrase Kentucky Sen. Rand Paul, what’s the point in replacing a program that subsidizes, taxes, punishes and practices conniving cronyism with a policy that promises a “refundable tax credit” (subsidizes), financially castigates those with good insurance (taxes), forces individuals who allow their coverage to drop to pay 30 percent more to insurance companies just to get reinstated (punishes) and props up insurance companies with $100 million of “reinsurance” funding (conniving cronyism)?

Nothing offered by Washington in either of these approaches effectively addresses the primary culprit in the current health-care fiasco: cost.

Forcing insurers, for example, to cover an array of 10 “essential health benefits” – from maternity care to mental health and drug abuse – greatly drives up the cost of premiums for everyone.

Why, for example, is a 65-year-old man forced to purchase a health-insurance plan that includes maternity coverage?

Such mandates drive up the cost of his plan, and, depending on his financial status, may require a taxpayer-provided handout to help him afford the premium, making him dependent on government to pay for his insurance that includes coverage for services he neither wants nor needs.

If we’re going to include government subsidies in our health-insurance policy, why don’t we at least do it in a way that actually helps some folks truly in need without penalizing everyone else?

Supporters fear getting rid of Obamacare would result in really sick people with longstanding illnesses being left without access to adequate coverage.

It doesn’t have to be that way if privately run high-risk pools are allowed as part of any “replacement” agreement.

Just like swimmers “share” the pool’s water, so participants with preexisting health conditions divvy up coverage costs.

Since participants in such a plan offer a much higher risk of filing claims and using health-care services, premiums will be higher than those of healthy consumers in the individual market.

Government can intervene in a limited manner by providing subsidies to people in these pools that help bridge the gap between lower incomes and higher premiums.

Taking this approach reveals a stark contrast between a safety-net program and sledgehammer-to-an-ant approach that happens when government tries to run the entire health-care system.

It’s the distinction between offering food stamps to low-income individuals to purchase their groceries versus government running the grocery stores.

Witness the disaster known as “Section 8 housing” and understand: there’s a considerable difference between government offering housing vouchers to assist lower-income citizens in finding a place in the private marketplace to rent and the demonstrated public-housing debacle found in cities in the commonwealth and across the nation.

Such a policy would help folks with preexisting conditions engage in their own care as they shop to find a plan that works best for them – the process of which will expose them to what their coverage truly costs and the care they can expect to receive.

Neither the ACA nor the ACHA does much of anything to engage individuals – with or without preexisting conditions – in their own care, especially when it comes to knowing the cost of products like prescription drugs or services such as surgeries.

The combination of consumers not knowing anything about the price tag of their care while government mandates products and services insurers must provide and then turns around and subsidizes them offers little incentive to providers to control costs – the primary obstacle to making America’s health-care system great again.

Jim Waters is president of the Bluegrass Institute for Public Policy Solutions, Kentucky’s free-market think tank. Read previous columns at www.bipps.org. He can be reached at jwaters@freedomkentucky.com and @bipps on Twitter.

Bluegrass Beacon – Obamacare: Public policy malpractice

BluegrassBeaconLogoReviews on cable news and social media of retired Kentucky Gov. Steve Beshear’s response on behalf of the Democratic Party to President Donald Trump’s first – and powerful – speech to a joint gathering of Congress aren’t great.

Speaking while seated in a diner with a small group of attendees who appear largely impassive in a let-us-know-when-we-can-get-back-to-the-pie-and-coffee sort of way, Beshear’s canned and casual approach made it seem more like he was headed to a backyard barbecue than offering a serious response to the commander-in-chief’s weighty address.

“Small and stunty,” panned liberal MSNBC commentator Rachel Maddow.

However, “to be fair to Beshear, going after that Trump speech is like taking the stage after a U2 set with nothing but a ukulele in your hands,” radio talk-show host Buck Sexton tweeted.

If life hands you a ukulele, at least find an effective composition to play.

Nothing is ever as effective as truth – especially in these days of fake news and alternative facts.

Alas, it seems all Beshear can locate is “Obamacare’s Concerto for Ukulele and Liberals in F (for Failure) Minor” as he remains stuck on maintaining that 22 million more Americans, including a half-million Kentuckians, “now have health care that didn’t have it before.”

At least 14.5 million of those Americans – including more than 400,000 Kentuckians – got their coverage through the misnamed Affordable Care Act’s expansion of Medicaid eligibility, which simply means that all previously uninsured citizens on Medicaid now have is a card in their pockets identifying them as government-program beneficiaries.

No assurance of actual care exists.

But that’s just one of the problems with off-key claims by Beshear and his fellow Obamacare supporters. Consider also:

  • Obamacare provides a costly barrier to needed care.

A Families USA study shows that premiums for high-deductible plans purchased through Obamacare’s exchanges are increasing by double-digit amounts and more annually – 116 percent in Arizona last year alone – resulting in one in four of those customers skipping doctor’s appointments and medical tests while struggling to pay the bigger invoices.

How does this add up to better care or lower costs?

  • Labor-force participation is dropping in states using Obamacare to expand Medicaid.

While Beshear spoke of unemployment-rate drops, fiscal experts are more concerned about Obamacare’s impact on discouraging people from even looking for work.

Georgetown University researcher-turned government analyst Tomás Wind reports that “expanding Medicaid is associated with a 1.5 to 3 percentage point drop in labor force participation” in states that chose to join in the expansion.

  • Obamacare perversely drives up costs then punishes individuals who work extra to pay for it.

People who’ve taken extra jobs to cover double-digit increases in premiums for policies obtained through Obamacare’s exchanges risk abruptly losing thousands of financial-aid dollars.

Tort reformer Ted Frank of the Manhattan Institute Center for Legal Policy used the Kaiser Foundation’s Health Insurance Marketplace Calculator to show how a 62-year-old earning $46,000 in a high-cost area suddenly loses the $7,836 tax credit that helps cover his premium if he earns just $22 more.

Hans Bader of the Competitive Enterprise Institute in noting Frank’s example writes that while it makes sense to “gradually phase out” subsidies for those whose incomes rise and who need less government help, Obamacare takes a “far more extreme and indefensible” approach.

“It suddenly takes away thousands of dollars in subsidies when many people earn a few extra dollars – blindsiding many of them in the process,” Bader writes. “… That leaves them much worse off than if they had never earned that extra income, potentially leaving them poorer for taking on a second job to pay the costs of their health insurance.”

It’s so severe that our 62-year-old will have more take-home pay if he earns $46,000 than if he reaches $55,000.

Frank’s conclusion: “This is just public policy malpractice.”

Jim Waters is president of the Bluegrass Institute for Public Policy Solutions, Kentucky’s free-market think tank. Read his weekly Bluegrass Beacon column at www.bipps.org. He can be reached at jwaters@freedomkentucky.com and @bipps on Twitter.

Bluegrass Beacon – Required: Full, fast repeal of Obamacare

BluegrassBeaconLogoRepublicans kept control of the Senate and House of Representatives in Washington after sending an Obamacare-repeal bill to the desk of the law’s namesake last January and also won the White House on a campaign platform of dismantling the disastrous health-insurance policy.

It didn’t hurt them in Kentucky, either, where the GOP won control of the House for the first time in nearly a century and now hold a supermajority in both chambers.

What will the Grand Old Party in Washington do with this momentum?

Not only is the first 100 days of this new Congress the right time to get rid of Obamacare, it will never be easier to meet demands for full repeal by impatient voters in no mood to accept a new coat of paint or touch-up job.

It must be dismantled “root and branch,” as Senate Majority Leader Mitch McConnell, R-Ky, said.

No portion of Obamacare serves as a better example of the need for immediate and complete repeal than the Medicaid expansion, which created a new welfare category for able-bodied adults, resulting in one out of three Kentuckians becoming dependent on government-run health care.

Since its launch, enrollment and costs in states choosing to opt in exploded.

While about 188,000 were originally expected to sign up for the program in Kentucky, 430,000 – more than double the projected maximum enrollment – ended up enrolling.

The result? The truly needy got pushed to the back of the line while working-age, non-disabled adults get free welfare.

Kentucky Gov. Matt Bevin’s administration is seeking to address this situation in its pending waiver request of the federal government, which doesn’t affect any Kentuckian enrolled in Medicaid before its expansion; neither does it change benefits for children, expectant mothers or the medically frail.

It merely requires able-bodied adults who enrolled in Medicaid as part of the expansion to, as Bevin insists, have “skin in the game” by offering healthy incentives rather than encouraging dependency.

Ultimately, the goal is for recipients to engage in their own employment and health care so they move out of safety-net programs meant to be transitional and temporary into private, traditional and permanent employer-provided insurance plans that provide better and more immediate care.

This new welfare program that voters clearly don’t want also threatens to crowd out funding for infrastructure, public safety, education and public-pension crises – taxpayer priorities in most states, including Kentucky.

Congress has reasonable options for ending this expansion.

It could freeze Medicaid enrollment by allowing current recipients to remain until no longer eligible, giving them sufficient time to explore alternatives.

Starting the rollback now would buoy voters’ confidence that the majority party plans to keep its longstanding repeal promise and free up limited resources for the truly vulnerable, including 2,000 Kentuckians with intellectual and developmental disabilities currently languishing on Medicaid waiting lists.

This freeze approach has worked in other states, including Maine and Arizona, where able-bodied enrollees immediately returned to a life of independence, instantly loosening limited taxpayer dollars for use toward ensuring access to care for truly vulnerable residents.

Congress should also implement two reforms to preserve Medicaid for the truly needy: require work for able-bodied, working-age adults on Medicaid as Bevin and other governors support and allow states to check Medicaid eligibility more frequently to remove fraudsters.

Reform cannot happen too soon.

McConnell rightly insisted: “We must act quickly to bring relief to the American people.”

Each day the costly and unpopular Obamacare policy lingers is a day too long.

Anything less than immediate, full and unvarnished repeal would be a violation of voters’ trust and could – and should – have severe ramifications during upcoming elections.

 Jim Waters is president of the Bluegrass Institute for Public Policy Solutions, Kentucky’s free-market think tank. Read his weekly Bluegrass Beacon column at www.bipps.org. He can be reached at jwaters@freedomkentucky.com and @bipps on Twitter.

Bluegrass Beacon – Medicaid reform: Compassionate or cruel?

BluegrassBeaconLogoAn example of how the British government in the 19th century used the magic of incentives to improve survival rates of prisoners transported on ships to Australia could offer clues about how to right Kentucky’s listing Medicaid program.

For years, barely half the Australian-bound prisoners survived these voyages.

Despite ardent appeals from church, humanitarian and government leaders imploring ship captains to improve conditions, survival rates failed to change.

Finally, social reformer Edwin Chadwick recommended offering different incentives by adjusting how ship captains were compensated.

Chadwick suggested that instead of paying captains a fee for each prisoner who walked onto their ships in England, they would be paid only for prisoners who walked off ships in Australia.

Changing the incentives for captains immediately and dramatically improved survival rates to more than 98 percent.

Captains now protected prisoners’ health and well-being by providing them with better food and hygiene during their passage, as well as reducing the number of inmates crowded into each ship.

Incentives achieved what even appeals from the clergy failed to accomplish.

The right kind of inducements also can bring about some dramatic improvements in Kentucky’s health-insurance policy.

Adding hundreds of thousands of Kentuckians to Medicaid by expanding eligibility resulted in dangerously overcrowding the commonwealth’s Obamacare ship.

Close to 30 percent of Kentucky’s entire population is now crammed into this tilting vessel.

Supporters of the government-run plan brag about and receive nationwide acclaim for building such a beautiful, shiny sparkling ship.

Yet stroll through the lower decks and you will find an overloaded vessel with humiliating conditions from which too many enrollees may never exit – unless incentives are changed.

Plus, as degrading as the conditions on those British ships were, the captains always knew their destination.

However, a major point of confusion concerning Kentucky’s Obamacare ship is its true terminus.

Not everyone agrees that the anchor of government dependency should be lifted, allowing this ship to sail into a harbor filled with opportunities for able-bodied adult Kentuckians to find decent jobs and earn a good living in order to achieve the kind of lifestyle that allows them to purchase their own health-insurance plans and receive care from doctors they choose.

Opponents of Gov. Matt Bevin’s Kentucky HEALTH plan – which seeks to improve the chances of most of the recent Medicaid enrollees reaching a destination of dignity by paying a small premium, getting treatment for an addiction, training for a job or volunteering in their community – seem wholly uninterested in allowing anyone off the ship.

They go to great lengths to avoid confronting their antagonism toward teaching fellow Kentuckians to fish instead of keeping them dependent on government fish.

They also often attempt to change the conversation altogether by focusing on groups that will experience little, if any, change should Washington approve the Bevin administration’s proposed reforms.

Absolutely nothing in Bevin’s plan would, for example, change benefits for children, pregnant women, the disabled or poor.

Still, a letter writer in western Kentucky thinks I’m “mean-spirited” and “lacking compassion” because I support incentives designed to get prisoners off the ship, out of a defeated and miserable lifestyle into a victorious, productive life.

How compassionate is it to adamantly oppose incentives that will keep Kentucky’s Medicaid ship from sinking by sailing into the harbor and unloading able-bodied adults crammed onto its decks, giving them the opportunity to move into a place where they can contribute greatly to our society and maybe even help others?

If the Obama administration wants to show true compassion, it not only will approve the Bevin administration’s waiver request to implement the HEALTH plan’s thoughtful and reasonable incentives, it will do so immediately and enthusiastically.

Jim Waters is president of the Bluegrass Institute; Kentucky’s free-market think tank. Reach him at jwaters@freedomkentucky.com. Read previously published columns at www.bipps.org.

Testimony offered to Senate Health and Welfare Committee opposing legislative approval of Kynect and Medicaid expansion

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The following is an edited presentation of testimony offered by Bluegrass Institute CEO Jim Waters to the Kentucky Senate Health and Welfare Committee on April 11, 2016, in Frankfort.

Good morning ladies and gentlemen. I’m Jim Waters, president of the Bluegrass Institute for Public Policy Solutions at bipps.org. The Bluegrass Institute is a free-market think tank focused on offering common sense, economically sound solutions to Kentucky’s greatest challenges.

Certainly one of the great challenges faced by too many of our fellow Kentuckians is finding affordable health insurance that provides an acceptable quality of care. Yet while the intention of government programs – and of most policymakers who vote for them – is to help the less fortunate, they often end up not only falling far short of fulfilling those intentions, but actually harming the very constituency they are meant to assist.


When former Gov. Steve Beshear established the state-based exchange Kynect by executive order in 2013, his administration projected the online insurance marketplace would provide 332,000 uninsured Kentuckians with access to affordable coverage. Yet fewer than a third of that anticipated number actually ever obtained coverage through the state-based exchange.

Seventy-five percent of those who signed up for plans on the exchange are being forced to find a new insurer as the Kentucky Health Cooperative, the exchange’s largest insurer, is closing down after losing $50 million last year – the most of any of the 22 Obamacare-subsidized cooperatives nationwide.

Even if the co-op would have remained open, its request to raise premiums by 25 percent during this past year – had they remained opened – combined with the previous year’s 20 percent in rate hikes would no doubt have exacerbated the situation reported by a recent study by Families USA study showing that high-deductible plans purchased though the state exchanges have resulted in one in four of those customers skipping doctor’s appointments and important medical tests.

[Read more…]

Obamacare remains unaffordable, unpopular in Kentucky

“We have implemented a huge costly government program that is benefiting one in four Kentuckians. This is not gaining traction in Kentucky. It still remains very unpopular among a significant number of Kentuckians.” –Bluegrass Institute President Jim Waters on the Affordable Care Act

Click here to read the story in the Bowling Green Daily News.

Bluegrass Beacon: Executive-orders weapon a two-edged sword that cuts Kynect both ways

BluegrassBeaconLogoGov. Steve Beshear in July 2012 issued an executive order creating Kynect, a state-run health insurance exchange heavily dependent on federal subsidies.

Gov.-elect Matt Bevin in the 2015 gubernatorial campaign promised to undo – also by executive order – programs created by the misnamed Affordable Care Act, calling it “a disaster for Kentucky’s taxpayers.”

Beshear created Kynect by executive fiat out of frustration with the failure of the politically gridlocked legislature to climb aboard Obamacare’s train as it huffed and puffed through the Bluegrass State.

Legislators’ concerns – members of both parties wanted to slow that train down – have again been confirmed with the recent announcement by the Kentucky Health Cooperative, Kynect’s largest insurance provider, that it’s shutting down.

The co-op, which has sold 75 percent of the policies on Beshear’s exchange, is closing down after losing $50 million last year – the most of any of the 22 Obamacare-subsidized co-ops nationwide.

Kentucky Republican and Senate Majority Leader Mitch McConnell effectively drove home the point about how this failure overlaps the entire Obamacare debacle in causing real harm to real people.

Referencing the most-deceptive statement ever – and repeatedly – made about federal health-care reform by President Obama himself that “if you like your health care plan, you keep your health care plan,” McConnell noted that the 51,000 Kentuckians losing their plans because of the co-op’s shutdown “may now be losing the health insurance they had and liked twice within the past three years because of Obamacare’s failures.”

Beshear waves the protests aside, claiming it’s really not a big deal since those obtaining insurance through the cooperative still have multiple choices between insurers on the exchange.

But what if they want to keep their existing plan?

Only minor surgery on this policy is required to discover: Obamacare is an absurdly schizophrenic scheme that both forces people who don’t even want a plan to purchase one or face IRS penalties while at the same time causing people to lose plans they had and liked.

It’s also an unsustainable policy.

How many businesses, for example, could bleed at the rate of the co-op and keep their doors open?

It’s an uncertain policy, especially in terms of the federal government’s failure to keep its promise to prop up plans – like the soon-to-be-defunct Kentucky co-op, which bled cash while funding claims of previously uninsured – and unhealthy – clients who rushed to the doctor’s office after obtaining a Kynect card.

The feds, which pledged to assist state exchanges forced to pay out far more in claims than originally anticipated to cover these losses, sent less than $10 million of the $77 million expected by the Kentucky co-op.

Not even the co-op’s steep premium increases during the past two years could plug such a gap.

Allow for the fact that no federal bailout money will be provided to Kynect after 2016 – resulting in Standard and Poor’s conclusion that Kynect is in serious financial trouble – and the wisdom of legislators wanting to move slower is justified.

Considering all but one of Kynect’s insurers hiked premium rates this year and a Families USA report indicating one in four people with insurance plans purchased through government-operated exchanges skip doctor’s visits and important medical tests because of struggles to pay premiums and high deductibles – with the number being closer to one in three among poorer enrollees, Bevin’s assessment on the campaign trail that Obamacare is a “disaster” is more than defensible.

Finally, the likely unconstitutionality of a unilateral executive order creating a government program involving taxpayer expenditures – which, gridlocked or not, remains the legislature’s prerogative – means Beshear’s successor has an airtight case, arguably even an obligation, to rid the commonwealth of the Kynect disaster.

Jim Waters is president of the Bluegrass Institute, Kentucky’s free-market think tank. Reach him at jwaters@freedomkentucky.com. Read previously published columns at www.bipps.org.

Bluegrass Beacon: Obamacare’s king and his court

BluegrassBeaconLogoEditor’s note: This column contains revisions from the original version that was released to newspapers prior to the Supreme Court’s King v. Burwell decision.

The Supreme Court’s disastrous King v. Burwell decision provides a relevant and timely opportunity for thoughtful Obamacare critics of the “repeal-and-replace” stripe to push President Obama’s administration to return control of health-care policy to where it belongs: the states.

Both do-gooder progressives and squishy conservative-types should remember that bullying states to establish exchanges and individuals not only to purchase health care but also be forced to pay for goods and services they neither want nor use – subsidies or not – is noticeably missing from the Constitution’s enumerated purview of the federal government’s power.

It’s bad enough that Obamacare unconstitutionally expands such reach with its 2,700-page bill and ensuing 11.6 million additional words regulating the policy.

Worse, when Obama’s own law proves inconvenient in his attempt to force all Americans to participate, the president’s pattern is to do what he’s consistently done with the Constitution and even the obvious wishes of the people on myriad matters, including health-care policy: ignore them.

The Supreme Court decided Obama can disregard his own law, which unambiguously limits federal subsidies to health-insurance policies purchased through state-run exchanges.

Still, it’s worth reminding that Obamacare’s genius designers admit they did not include subsidies for Americans purchasing insurance through exchanges established by the feds because they know the Constitution doesn’t empower Washington to force states to establish exchanges.

Instead, they made subsidies available only through state-run exchanges, believing such a policy ploy would result in making it impossible for states to resist the easy money of subsidies dangled in front of both legislators and their constituent-recipients of those benefits.

While Kentucky was one of 13 states and the District of Columbia to take the bait, more than two-thirds of states refused – an indication not only of Obamacare’s unpopularity outside the Beltway but also of just how deep state lawmakers’ concerns run over the reform’s uncontained costs, unknown consequences and uncertain future.

Obama responded by ordering the beloved IRS to issue a regulation providing subsidies for health insurance purchased on federal exchanges, notwithstanding the law that bears his own name.

A significant impact of the court’s unlawful ruling allowing people who purchased insurance through a federally established exchange to receive subsidies is that it also lets the despised mandates requiring employers and individuals to provide and purchase coverage, respectively, to continue – as Obamacare allows such mandates only where subsidies also are permitted.

Had the court ruled against the subsidies, it also would essentially have ended the mandates and caused Obamacare itself to implode.

“They would be pulling the fangs out of Obamacare,” David Adams, a vocal critic of the reform in Kentucky, said.

Even with the court’s ruling, Obama could pressure Congress to “just fix three words” so the coverage of millions through this big-government approach is forever sealed.

However, a study designed by the Leavitt Partners to assist governors and state legislators in developing a productive response to the court’s ruling encourages state policymakers to seize the opportunity and go to Washington – literally – in bipartisan fashion and push the administration to give them the flexibility to “advocate solutions that enhance federalism,” noting that “the administration has not shown great flexibility on ACA implementation affecting states.”

University of Kentucky economist John Garen isn’t overly optimistic about “the present administration” granting waivers that would allow states to try some more innovative health-care and insurance policies.

“But if a group of 15-20 states presents a unified set of waivers, then who knows?” Garen, Ph.D., said.

Kentucky, which subsidizes 70 percent of the 109,000 Kentuckians purchasing insurance through its state exchange known as Kynect, could profit greatly from a return to federalism that allows experiments via interjecting free-market principles into health-care policies in the states, the laboratories of democracy.

More on why and how that can happen in my next column.

Jim Waters is president of the Bluegrass Institute, Kentucky’s free-market think tank. Reach him at jwaters@freedomkentucky.com. Read previously published columns at www.bipps.org.