Nikki Haley on Health Care
But as a state, and as an elected government, we will not be victims in this process. We rejected the federal government's less than generous offer to run a state exchange, an offer that would have Washington bureaucrats dictating the exchange and South Carolinians paying for it.
And, with your help, we emphatically said no to the central component of ObamaCare, the expansion of a broken Medicaid program that is already cannibalizing our budget, and would completely destroy it in the years to come.
These were not decisions made lightly, without thought or analysis. But I am fully convinced that South Carolina will be better for them, and I pledge to you this: we will continue to fight ObamaCare every step of the way.
I had pledged, as governor, to lead a coalition of governors to fight Obamacare and allow the states to offer real solutions to our health-care crisis. I was dead set against Obamacare, but Sheheen wanted to have it both ways. Pressed on the issue in the debate, he claimed to support some parts of the Obama plan but not others. There were "good and bad" parts of the bill, he insisted.
"Senator, you can't split the cow," I replied. "You can't say you like certain parts of it and not other parts. We're stuck with the whole cow."
Sheheen's answer was petty and insulting, even for him. "We need a governor with the intelligence and the ability to say when things are good and things are bad," he said. He was calling me unintelligent! The crowd got it and booed the cheap shot.
I have been consistent as a candidate and as governor in my position to Obamacare. The president's approach is wrongheaded and unconstitutional. He's pouring more costs into the system through federal mandates instead of taking costs out of the system through transparency and individual responsibility.
But there is one bright side to the president's plan: It has sparked a conversation about health care that is badly needed. Our healthcare problem is real. In South Carolina we have a large Medicaid population, and health care is the main driver of our budget deficit. But our health-care problem is also unique to our state--it's not the same as the health-care challenges in states like MA or NE. Our challenges are mainly poverty and education.
We have good services, but we need to educate people on how to better utilize them and on how to pay more attention to their health.
I told Obama that his health-care plan imposed mandates that South Carolina just couldn't afford. Our annual budget is $5 billion, and we had calculated that his plan would cost us $5 billion over the next 10 years. We expected to see 30% to 40% of our private companies drop their employees' coverage and force their workers into the public system. My question had 2 parts, I told the president. Would he repeal Obamacare? And if not, would he allow South Carolina to opt out of the system?
I ask that we strike the proviso prohibiting the HHS Director from setting rates paid to providers through Medicaid. South Carolina is the only state in the nation that doesn't give our Medicaid director that flexibility, and with all due respect, we can't be the only state that has it right.
As Governors, we are writing to you regarding the excessive constraints placed on us by healthcare-related federal mandates. One of our biggest concerns continues to be the Maintenance of Effort (MOE) provisions of the Patient Protection and Affordable Care Act, which prevent states from managing their Medicaid programs for their unique Medicaid populations. We ask for your immediate action to remove these MOE requirements so that states are once again granted the flexibility to control their program costs and make necessary budget decisions.
Every Governor, Republican and Democrat, will face unprecedented budget challenges in the coming months. Efforts to regulate state operations impose greater uncertainty on our budgets for oncoming years and create a perfect storm when coupled with the current state of the economy.
Health and education are the primary cost drivers for most state budgets. Medicaid enrollment is up. Revenues are down. States are unable to afford the current Medicaid program, yet our hands are tied by the MOE requirements. The effect of the federal requirements is unconscionable; the federal requirements force Governors to cut other critical state programs, such as education, in order to fund a "one-size-fits-all" approach to Medicaid. Again, we ask you to lift the MOE requirements so that states may make difficult budget decisions in ways that reflect the needs of their residents.
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