In their campaign to secede from federal health-care reform, arch-conservatives in the Legislature are pushing a scheme to wrest control of health-care regulation from Washington and vest it in a compact of states. In any atmosphere other than the tea party politics of today, this would be considered a joke.
SB208 would ask Congress "to return the authority to regulate health care to the member states." This would give the states in the compact the power to opt out of the federal Affordable Care Act, pejoratively known as Obamacare. Each state could adopt its own regulations, keeping or rejecting existing federal laws and rules as it chose. It would receive federal funds each year in a block grant equivalent to the amount the federal government spent on Medicare, Medicaid and other federal health-care entitlements, excluding those of the Defense Department, Veterans Affairs and American Indians, in that state in 2010. A formula would adjust that figure annually based on population and inflation.
This bill is political grandstanding of the first order. To understand it, you have to remember that one of the ways that the ACA would expand health-care coverage to uninsured people in the United States is through a broadening of Medicaid to make more people eligible. If SB208 were to succeed, Utah could reject that expansion, as well as the individual insurance mandate and the associated penalties that are the most controversial provisions of the Affordable Care Act.