Tea Party activists have unleashed a new weapon in Tennessee in their fight against the national health care reform law. It’s part of their broader death-by-a-thousand-cuts strategy that stretches from Congress to state legislatures to the courts.
The law’s foes focused last year on pre-empting the federal overhaul with their so-called Health Freedom Act, a measure of suspect constitutionality. This time, they are pushing legislation to create an interstate compact to supplant Medicaid, Medicare and all other federal health care programs. Under this bill, states in the compact would run the programs as they see fit with their shares of federal money — $16 billion in Tennessee’s case.
“Other states are joining us in this effort,” said Senate Judiciary Committee chair Mae Beavers, R-Mt. Juliet, the bill’s sponsor. “An interstate health care compact is a powerful vehicle for states to confront the federal health care law.”
Beavers said her bill “essentially provides a permanent waiver for each member state to create whatever health care regulations the legislature deems best for the citizens of that state.”
She envisions “a secure funding stream and maximum flexibility for state legislators” that “will create the conditions for multiple solutions to emerge to the health care crisis.”
“We’re going to look for solutions outside the box,” said Senate Speaker Ron Ramsey, another friend of the Tea Party. “This is the way of allowing the states to be those laboratories to figure out the best way to provide those services and not have them pushed down by the federal government on the states.”
Sound too good to be true? Even some supporters concede it most likely is. Leaving aside the ability of the states to manage such mammoth programs, it would take congressional approval, and even a Republican-dominated Congress might think hard about surrendering billions of dollars in federal money to the states with no strings attached.
Tami Kilmarx, president of the Tennessee Tea Party, compared the bill to the failed Republican attempt to repeal health care reform in Congress this year.
“It may be pie in the sky in a lot of ways,” Kilmarx said. “But we’re using everything at our disposal to push back against federal government. This may fail. It may not. The repeal has obviously failed.”
Last session’s Health Freedom Act purported to junk the national health care law. In a formal opinion, Tennessee Attorney General Bob Cooper pointed out that the measure likely was invalid because federal laws supersede state laws under the Constitution’s Supremacy Clause.
Still, the state House and Senate each passed a version of the legislation. They couldn’t reconcile the differences so neither bill became law. That was mainly because of political squabbling between the two champions — Sen. Beavers and then-Rep. Susan Lynn, another Mt. Juliet Republican who ran against Beavers in last year’s elections and lost.
Conservatives are preparing to push the Health Freedom Act again this session, although even Ramsey acknowledged it’s mostly about sending a symbolic message against an overreaching federal government.
“The Health Freedom Act is important because it makes a statement at least that we’re just not going to roll over in the state of Tennessee,” Ramsey said.
More realistically, conservatives will try this session to punish Cooper for refusing to join a lawsuit by numerous states challenging the constitutionality of the health care law. A resolution would amend the state constitution to require the popular election of the attorney general, who now is appointed by the state Supreme Court.
Cooper, a Democrat, said there was no point in spending the state’s money on the lawsuit when other states were doing the job. But that explanation didn’t satisfy Republicans in the legislature.
“We will have a bill here in the state Senate and the state House to allow our attorney general to be elected,” Ramsey said. “The attorney general is answerable to no one. We’ve asked him on several occasions to join in this lawsuit, and he just refuses to do that. I think the time has come to elect our attorney general in Tennessee.”
In the lawsuits challenging health care reform, the score is now tied, with two federal judges deciding in favor of the law and two ruling that the individual health insurance mandate exceeds congressional authority under the Commerce Clause.
“It’s horrible to use the Commerce Clause to assert federal will against the individual,” Kilmarx said. “If I want to purchase health insurance, it’s my choice. It’s my choice to be insured or not insured. I happen to be insured. I work. I don’t think there ought to be a mandate coming down from on high that we have to sink this state and the citizens in debt over this.”
Gov. Bill Haslam joined Republican governors in a letter asking President Obama to expedite the process for the case to reach the United States Supreme Court as soon as possible.
“Beyond the merits of this issue …” Haslam wrote, “our people deserve to know the future of how their state governments will be structured, how their wallets will be affected, and how their choices in health care will be determined.”