The Good, The Bad, and The Ugly of House Republicans’ Obamacare Replacement

On Thursday, prior to lawmakers returning home for the President’s Day recess, House leadership gave them a brief outline of policies likely to be included in “repeal-and-replace” legislation introduced next month. While this “full replace” strategy likely will encounter additional obstacles and delays, as I outlined last week, it’s worth analyzing the specific policies being proposed at this point, to see how they shape up.

The Good

State Innovation Grants: While sounding new to some, this concept was first introduced in 2009 in the House Republican alternative to Obamacare, and later reprised in an Obamacare alternative introduced by America Next and then-Gov. Bobby Jindal (R-LA) that I helped draft. The program provides federal incentives for states to reform their insurance markets in ways that will lower premiums, expand access, and ensure coverage for individuals with pre-existing conditions (i.e., high-risk pools).

Health Savings Accounts (HSAs): In recent years, health savings accounts have become a popular and effective way to reduce health care costs. In addition to making other minor reforms, the Republican plan would roughly double HSA contribution limits. This change would allow individuals—particularly those just establishing HSAs—to save more for medical expenses, while not sparking the over-consumption that an unlimited HSA might incentivize.

Medicaid: With respect to Obamacare’s expansion of Medicaid to the able-bodied, the House document says expansion states “could continue to receive enhanced federal payments for currently enrolled beneficiaries for a limited period of time” (emphasis mine). This language would effectively adopt my earlier proposal of freezing enrollment in the Medicaid expansion—perhaps the most effective way to unwind the Obamacare entitlement. Unfortunately, other changes (described below) might have the opposite effect.

The Bad (or Questionable)

More Obamacare? In discussing the transition period between Obamacare and the new regime they seek to establish, the House document states “the Obamacare subsidies are adjusted slightly [sic] to provide additional assistance for younger Americans and reduce the over-subsidization older Americans are receiving.”

Regardless, it seems questionable whether the answer to Obamacare’s problems lies in either more spending or another federal regulation that would only slightly ease the current micromanagement of health insurers. The focus should remain on repealing Obamacare, not fixing Obamacare.

Medicaid: At minimum, the House paper leaves more questions than it answers here, providing few specifics on the formula for a reformed Medicaid program (either block grants or per capita caps) in the future. In last year’s Better Way plan, House leadership proposed creating a “base year” for a reformed program of 2016, but that specific policy point did not appear in last week’s document.

Since release of the Better Way plan last year, new data from actuarial reports on Medicaid have shown how states that expanded Medicaid have “gamed the system” to increase their federal funding. Specifically, participants in the Medicaid expansion have averaged 14 percent higher costs than non-expansion enrollees—exactly the opposite of the actuary’s projections prior to the law’s implementation. That’s because states have used the prospect of the up to 100 percent federal match for expansion populations—so-called “free money” from Washington—to pay higher physician reimbursements.

Health Savings Accounts: While increasing contribution limits will increase HSA take-up, one other change should take precedence: Allowing HSA funds to be used to pay for insurance premiums, which is currently prohibited in most cases (except for COBRA continuation coverage, during periods of unemployment, and other limited circumstances). Allowing account funds to pay for premiums would represent a quantum leap forward in consumer-driven health care, by creating a defined-contribution model: Small businesses that cannot afford to purchase coverage for their workers can make predictable HSA contributions, which employees can then use to pay for health expenses, or to fund their own health insurance.

It is possible that the budgetary cost of ending the restrictions on premium payments prompted leadership staff to work instead on increasing the contribution limits. But the former should come before the latter, for multiple reasons: Allowing people to use account funds to pay premiums will create greater political movement to increase the contribution limits, while increasing the contribution limits now will make ending the premium restrictions more costly later. Both are positive reforms, but for multiple strategic reasons, ending the premium payment restrictions should take precedence over increasing the contribution limits.

The Ugly

New Entitlement (Funded by New Taxes?): The linchpin of the House plan lies in its system of advanceable, refundable tax credits—a new program of spending that would see the federal government writing “refund” checks to individuals with no income tax liability. However, the proposal likely will not receive a favorable score from the Congressional Budget Office (CBO) about the number of individuals covered by health insurance, at least compared to Obamacare.

Most economists agree that the tax treatment of employer-provided health insurance encourages over-consumption of health insurance and health care. However, there are better ways to reform the tax treatment of health coverage—and provide parity between employer-sponsored and individually purchased insurance—without raising taxes overall. The American people do not support repealing Obamacare’s revenue increases only to replace them with other tax hikes.

Therein lies the great disappointment of the House proposal. While in 2008 Barack Obama campaigned for his plan by saying it would reduce health-care costs, he governed with a singular focus on increasing the number of individuals with health insurance, and in so doing raised costs and premiums for millions of Americans. Going down the same failed Obamacare approach of more taxes and more spending will not lower health costs. That, and not repealing and replacing Obamacare’s taxes and spending, should be House Republicans’ ultimate objective.

This post was originally published at The Federalist.

Gov. Jindal Op-Ed: Supreme Court Decision Is Not the End of the Debate

As a matter of law, the Court’s decision upholding subsidies for states participating in the federally run insurance exchange, healthcare.gov, violates the plain text of Obamacare. The statute expressly restricted insurance subsidies to those individuals purchasing coverage through an “Exchange established by the state.” But just as Chief Justice Roberts three years ago decreed that the individual mandate functioned as a tax, even though both Congress and President Barack Obama stated that it wasn’t, the Court decided that “Exchange established by the state” meant any type of Exchange, whether established by states or by Washington.

It’s a sad outcome for the rule of law — and the English language. But when it comes to the political debate surrounding Obamacare, the Court’s ruling ultimately decides little. Of course, Obama, who took an entirely predictable victory lap yesterday, would have you believe otherwise. But we’ve seen his triumphalism before — and have seen it come crashing back to reality.

Three years ago, Obama stated he wouldn’t “refight old battles,” mere hours after seven Supreme Court justices — including his own former solicitor general — struck down the law’s mandatory Medicaid expansion as unconstitutional “economic dragooning” of the states. On election night 2012, the president promised to “move forward” — months before at least 4.7 million Americans received insurance cancellation notices thanks to Obamacare. And this April, the president arrogantly declared that “the repeal debate is and should be over” — mere weeks before his native state of Hawaii shut its failed insurance exchange, an effort the federal government spent more than $200 million funding.

So, much as the President would like the debate on Obamacare to be over, it isn’t. The debate persists in large part because the law has singularly failed in its prime objective: Containing health care costs. Consider why this Supreme Court case mattered so much to the administration in the first place. The law spends over $1.7 trillion on subsidized coverage to make insurance more “affordable,” largely to offset the new mandates and regulations that have raised the price of insurance.

And with myriad insurers proposing double-digit premium increases for next year — some as high as 50% — candidate Obama’s 2008 promise to lower insurance premiums by $2,500 per family is further away then ever. No wonder the law remains singularly unpopular. When it comes to winning the debate on Obamacare, there is still all to play for.

But in order to win, we conservatives first have to play. That means outlining our alternative vision for health care: How we would restore freedom and choice to a health care sector currently lacking for both — and most importantly, how we would slow, and hopefully reverse, the trend of skyrocketing health care costs.

As I write this, I stand as the sole major declared presidential candidate (with the possible exception of Bernie Sanders) to put forward my vision on health care, and an alternative to Obamacare. As proud as I am of my plan, that is a boast I wish I were not able to make. Because Republicans, from the top down, must outline a clear and coherent vision for health care to win the trust of the American people to repeal this President’s health law.

While we should be shouting our vision from the rooftops, many of my fellow candidates have managed barely a whisper about how exactly they would repeal Obamacare, or what they would do to tackle the main issue plaguing our health care system: rising costs. Sen. Mike Lee recently stated that lack of an Obamacare replacement plan should be a disqualifier for any conservative presidential candidate. He’s absolutely right. We owe it to the American people to release our plans well before November 2016, and to have a robust debate within our party about what should come after Obamacare.

Because, contrary to this President’s self-proclaimed edicts, yesterday’s Supreme Court decision is not the end of the debate on Obamacare.

Now that the Supreme Court has ruled, the debate shifts back to the elected branches of government — the ones that caused our health care mess in the first place. It is there that conservatives can complete our work to repeal Obamacare.

This post was originally published at Time.

Gov. Jindal Op-Ed: Obama Wrong to Hold Florida’s Funding Hostage

“If you like your plan, you can keep it.”

There’s a reason this so-called promise from President Obama was called the “Lie of the Year” by Politifact in 2013. At least 2.6 million people received cancellation notices because their health-insurance plans did not meet Washington bureaucrats’ standards. Some got a temporary, unilateral reprieve issued by the administration in response to the public outcry, but many were forced to find new — and more expensive — insurance.

Apparently, however, President Obama isn’t content to hold the “Lie of the Year” for 2013 — he wants to win the award this year as well. Because he’s threatening Florida’s existing Medicaid program unless the state accepts Obamacare, too.

The Sunshine State has engaged in major Medicaid reforms over the past several years, one element of which has been a Low Income Pool that funds uncompensated care. The pool is up for renewal on June 30, and last week the federal government threatened to withhold its $1.3 billion in funding unless the state expands Medicaid under Obamacare: “The state’s expansion status is an important consideration in our approach regarding extending the LIP beyond June.”

In other words: Expand Obamacare as we say — or we’ll cut off billions in funding. I’d call that kind of approach Mafia-style tactics, but to do so would be an insult to TV mob boss Tony Soprano.

On many levels, this administration’s position is just plain wrong.

First, Florida should concentrate its efforts on protecting the most vulnerable, for whom Medicaid was originally designed. According to the liberal Urban Institute, nearly nine in 10 potential recipients of the Medicaid expansion — fully 87.2 percent — are able-bodied, childless adults of working age. Census Bureau data analyzed by the Foundation for Government Accountability indicate that fewer than one-quarter (23 percent) of these able-bodied recipients work full-time; nearly half (46 percent) do not work at all. Particularly given these data, Florida is absolutely right to prioritize the needs of the elderly and individuals with disabilities over expanding Medicaid to able-bodied adults.

Second, the administration’s position violates the Supreme Court’s June 2012 ruling on Obamacare. Chief Justice Roberts’ ruling made Medicaid expansion optional for states. He specifically attacked the coercive nature of the law as written, calling it “economic dragooning that leaves the states with no real option but to acquiesce in the Medicaid expansion.” Even though the Chief Justice of the United States explicitly proscribed the notion of putting “a gun to the head” of states, the Obama administration is now doing just that — holding billions of dollars in Medicaid funding hostage.

Third, the actions the Obama administration has taken to foist its unpopular law on the public haven’t just been unconstitutional — they’ve been un-American. The attempt to intimidate Florida into accepting the Medicaid expansion bears echoes of 2009, when the administration set up a special email address asking people to report “fishy” information back to the White House. From encouraging people to rat out their friends then, to threatening billions of dollars in funding for state Medicaid programs now, Obama remains hellbent on selling a law the American people have repeatedly rejected.

Perhaps he should have spent more time focusing on health reforms people actually wanted — reforms that could lower the cost of care — rather than his radical ideological vision. That way the administration could have focused its efforts on preserving its own emails, rather than collecting others’ messages in an unsuccessful attempt to make Obamacare more popular.

But so long as the administration wants to continue its Chicago-style politics — support the machine or else — Congress should put a stop to this nonsense. The Congressional Review Act may provide one avenue to overturn the spiteful decision regarding Florida’s Medicaid program. Alternatively, Congress can pass legislation — either by amending existing laws, or by using its appropriations powers to block funding — that would prevent this administration, and future administrations, from linking other unrelated matters to the question of Obamacare’s Medicaid expansion.

Regardless of the avenue, Congress should act soon. The citizens of Florida, and other states, deserve more than to have their health-care systems turned upside-down just because Barack Obama cannot countenance the idea of anyone opposing his unpopular health-care law.

This post was originally published at the Orlando Sentinel.

Gov. Jindal Op-Ed: An Obamacare Debate Worth Having

Repeal is not enough.

Five years later, that much should be clear. The law’s ill effects — higher premiums, cancelled health plans, bureaucratic ensnarements for doctor and patient alike — have all been well documented. This spring, the American people also got to know for the first time how Obamacare has complicated the tax code — raising taxes for many, and causing confusion and headaches for everyone.

But it’s long past time for the American people to get to know what conservatives would do in Obamacare’s stead. Our healthcare system did face a major threat before President Obama took office — rising costs that threaten to overwhelm middle-class families, and the federal budget as well. But while candidate Obama promised in 2008 to tackle costs, and lower premiums by $2,500 for the typical family, President Obama instead focused on expanding government-run health coverage, and missing the mark on his premium promise by over $1 trillion.

So yes, by all means, let’s ask the question: “Obamacare — when have you stood up and fought against it?” But anyone who wants to ask that question should have a detailed answer to this one: “Obamacare — what would you do instead?” Because it’s not particularly courageous for conservatives simply to oppose a law that remains deeply unpopular with voters. We must tell people what we are for, and let the American people know exactly what we will do, and how we will do it.

That’s why I put forward my own plan to replace Obamacare last year. It’s a plan that focuses like a laser beam on slowing the growth of healthcare costs. It offers 16 specific, proven methods that can work to curb health spending — from Health Savings Accounts, to wellness incentives, to lawsuit reforms that can reduce defensive medicine practices, to more insurance options that can spur competition and bring down prices. Just as important, the plan repeals all of Obamacare’s trillion dollars in tax increases and doesn’t replace them with a single penny of revenue hikes.

Thankfully, more Republicans are finally starting to put out specific proposals about how to replace Obamacare. I’m glad — that’s long since overdue. I think this issue is so important to conservatives, to our party, and to the future of our country that I want to lay down a very clear marker. I’m willing to debate anyone with a serious healthcare plan who wants to compare their Obamacare replacement plans with mine.

Obamacare is so harmful to our country — our health system, our economy and jobs, and our freedom — that we simply must repeal it, and put in place good reforms that will undo the damage Obamacare has caused.

It’s become fashionable in Republican circles in Washington to say that the hour is past, and that it is now too late to repeal all of Obamacare, and to say that we will just have to try to change it best we can. That’s nonsense.

After Hillary Clinton’s health plan went down to defeat in 1994, the Left never stopped their fight. I’ll bet Mrs. Clinton even sent a few emails out about it.

We as conservatives must do the same — we must fight until we win, and put forward a good conservative replacement for Obamacare now and challenge the President to do the right thing.

As Sen. Mike Lee recently said in Iowa: “If a presidential candidate tells us that he wants to repeal Obamacare but doesn’t have a healthcare reform proposal of his own, then maybe we should keep looking for another candidate.”

Sen. Lee is exactly right. We have to fight for what we promised the American people. And putting out clear, specific plans to replace Obamacare should comprise a major element of that effort — because repeal is not enough.

This post was originally published at the Washington Examiner.

Gov. Jindal Op-Ed: Republicans Shouldn’t Try to Save Obamacare Subsidies in Wake of King Ruling

A Supreme Court ruling restoring the original language of Obamacare — nullifying the administration’s rule, and striking down subsidies in the 37 states — would have several knock-on fiscal effects. Because Obamacare’s employer mandate is directly tied to the subsidies — firms not offering coverage pay the penalty only if their workers receive federal premium assistance — the mandate taxes will disappear in those 37 states. Likewise, the individual mandate’s affordability test is linked to the subsidies; the mandate only applies if coverage is affordable after any premium subsidies received. Removing them will dramatically weaken the individual mandate, reducing both the number of people to whom it applies and the amount of revenue it will raise.

Eliminating the subsidies nationwide would therefore cut Americans’ tax liability by approximately $48 billion on net. Granted, these sums from CBO apply to all 50 states, while the King ruling would apply only to the 37 states that have not established exchanges. But the trend from the numbers is crystal clear: The tax reduction from eliminating the employer mandate, and weakening the individual mandate, outweighs any tax increase from eliminating the subsidies — meaning a favorable ruling in King v. Burwell would cut Americans’ taxes by many billions.

That’s a “solution” in search of a problem. If eliminating the subsidies represents a net tax cut, then restoring the subsidies — whether by states creating their own exchanges, Congress passing new legislation, or some combination of the two — would re-impose a sizable tax increase. Americans would pay billions more in higher taxes to fund the newly restored subsidies, making Obamacare that much more entrenched. What self-proclaimed conservative of sound mind would do such a thing?

Alternatively, some have talked about enacting a “compromise” that would restore the Obamacare subsidies while reforming some of the law’s new insurance requirements and regulations. But restoring the flow of subsidies means restoring the employer mandate, thus raising taxes. And even if such a “compromise” weakens or eliminates the employer mandate, the Obama administration — to say nothing of the insurance companies themselves — will hardly countenance a repeal of the individual mandate, which restoring the subsidies will only strengthen. So those seeking to restore the flow of subsidies will likely end up having to raise taxes on millions of Americans, in some way, shape, or form.

As they ponder both these facts and their response to King v. Burwell, conservatives would do well to remember President Bush’s view of his 1990 tax reversal: “I did it, and I regret it, and I regret it.” Republicans have spent the past 25 years fighting efforts to raise taxes — and the past five years fighting Obamacare — in an effort to restore the trust of the American people lost on that fateful day in October 1990. As we saw then, neither history nor the voters will be kind to those politicians who choose to break their word to the public. Here’s hoping that conservatives of all stripes have finally learned that lesson.

This post was originally published at National Review.

Gov. Jindal Op-Ed: Rebuttal to Ramesh Ponnuru

My op-ed this week regarding the need for conservative alternatives to Obamacare has prompted numerous responses, including one on these pages. I’m happy to continue this debate by explaining my plan further, and outlining why I believe it’s the preferable choice for conservatives to embrace.

In his column analyzing my plan, Ramesh Ponnuru criticized it on several counts. He calls its “great flaw” that the plan might disruption when compared to Obamacare. But while some may view that as a bug, others might view it as a feature. For instance, the millions of individuals who received cancellation notices might like the opportunity to purchase more affordable coverage without facing the Obamacare mandates that have jacked up their premiums. Likewise the six million Americans about to face the Obamacare mandate tax for the first time come April 15—or the millions more who will face more red tape as they have to apply to Washington for a mandate exemption.

Two other numbers bear particular emphasis. Last spring, the Congressional Budget Office estimated that delaying the individual mandate until 2019 would raise the number of uninsured Americans by 13 million. In other words, under Obamacare, 13 million Americans will receive health coverage because the federal government is forcing individuals under penalty of taxation to buy it. Making sure none of those individuals—many of whom may never have wanted to buy insurance in the first place—have their coverage disrupted would cost far more in taxes than any alternative to Obamacare would raise.

The second number is $2,500—that’s the reduction in premiums Barack Obama promised from his health plan during the 2008 campaign. But according to an America Next analysis last year, the President’s failure to deliver on that promise has cost the American people more than $1.2 trillion in higher premiums just from 2009 through 2013.

In critiquing my proposal, Ponnuru falls into the typical trap of the Left—to evaluate a health plan primarily, if not exclusively, by how many people it provides with insurance cards. I fundamentally disagree with that premise. The American people are worried first and foremost about the rising cost of health coverage—it’s what makes their health care unaffordable, and Obamacare unsustainable.

That’s why my plan emphasizes attacking rising health costs, and not expanding coverage—because focusing on the former is the best way to achieve the latter. Conversely, fixating on the latter—trying to mandate coverage through new regulations, taxes, and Washington diktats—will only make the former less attainable—raising health costs in a way that no regime of taxpayer-funded subsidies could ever sustain.

That said, my plan absolutely includes a safety net for the most vulnerable. It provides at least $100 billion for states to guarantee access for individuals with pre-existing conditions. Rather than dictating a top-down approach from Washington, our plan lets the states decide how best to increase access for their citizens. And it does so in a way that encourages states to reform their existing regulatory regimes—helping to bring down costs.

I believe this plan—focusing first and foremost on reducing costs, and doing so through the states, not Washington, DC—provides the best path forward, most closely adheres to conservative principles, and provides a telling contrast to Obamacare’s shortcomings and failures. To win elections, conservatives need to have better ideas, not merely mimic the ideas of the Left.

This post was originally published at Bloomberg.

Gov. Jindal Op-Ed: The GOP Mustn’t Offer Obamacare Lite

There is a secret that people outside of Washington, D.C., aren’t aware of right now: Some Republicans in Congress are on the verge of proposing an alternative to Obamacare that imposes new tax hikes on the American people.

On March 4, the Supreme Court will hear arguments in a case that could upend Obamacare completely. In King v. Burwell, the court — if it follows the plain text of the law, which says that only individuals purchasing coverage on an “exchange established by the state” are eligible for federal insurance subsidies — could cause disruption to individuals in the 36 states that did not establish a state exchange, and instead rely on the federally run healthcare.gov exchange. For this reason, many observers have argued that conservatives need to present an alternative vision of health reform before the court rules.

Take one major issue related to Obamacare: taxes. The law is chock full of them — no fewer than 18 revenue raisers totaling over $1 trillion through 2022.Yet several alternative proposals being discussed by Republicans don’t actually repeal the law’s tax increases. Instead, they repeal the law’s tax increases, only to replace them with new revenue hikes. So, rather than raise taxes by more than $1 trillion, as Obamacare did, these plans raise taxes by perhaps, say, “only” $500 billion.

This puts Republicans in the positions of being “cheap” Democrats, or Democrat-lite. We’ll raise taxes — but just … less than Obamacare. We’ll spend hundreds of billions on new entitlement programs — but just … less than Obamacare.

But the problem with programs that look like Obamacare is that they bring with them many of Obamacare’s problems. Remember when the Congressional Budget Office concluded that Obamacare will result in more than 2 million Americans working fewer hours, or leaving the labor force altogether? That’s because the law’s insurance subsidies are structured in ways that will cause individuals to work fewer hours, keeping their income low to maintain eligibility for subsidized insurance. Some so-called conservative health plans also have characteristics that will discourage work — even if perhaps less than Obamacare does.

So why talk about “conservative” health care reform if our vision turns us into cheap liberals? Why complain that Obamacare is expanding welfare and dependency, only to propose a similar — albeit smaller — program that could well have the same effects? If conservatives oppose Obamacare’s tax increases on the middle class, then why did one “conservative” health adviser propose accelerating the law’s tax on health plans by phasing it in sooner?

The reality is that while Beltway insiders in the elite salons of Washington can do and say whatever they want, the American people know better. A majority of voters — and even larger majorities of conservative and Republican voters — believe that “any replacement of Obamacare must repeal all of the Obamacare taxes and not just replace them with other taxes.” In other words, the voters won’t be fooled by quasi-liberal health plans masquerading in conservative clothing.

The other good news is that truly conservative health plans exist. Last year, I outlined a plan with America Next, the conservative policy group I founded. The plan focuses like a laser beam on controlling the health care issue that matters most to Americans — skyrocketing health costs. The plan empowers the states to enact reforms that can bring down costs, while also guaranteeing access for individuals with pre-existing conditions. Rather than stifling states with additional regulations from Washington, the America Next plan offers them incentives to improve their insurance markets in ways that offer more choices and lower costs. As a result, Americans should benefit from new avenues to buy portable health insurance they can own themselves — through their church, alumni group or trade association — and lower premiums, too. In fact, the Congressional Budget Office previously analyzed reforms similar to those in the America Next plan and found that they could reduce individual health insurance premiums by thousands of dollars per family.

I recognize there are other good conservative plans out there — and that’s great. For instance, the Republican Study Committee proposed reforming the tax treatment of health insurance without repealing and replacing the tax increases in Obamacare. We should have a robust debate and show both the Supreme Court and the American people that there are better ways to enact true reforms. But I don’t believe that any plan that repeals and replaces Obamacare’s trillions in taxes and spending is a conservative alternative — and the American people agree.

Recently, the left gave us an instructive lesson on why this debate about a conservative alternative is so important. The advocacy group Families USA released a report calling for a veritable orgy of new Obamacare-related spending — new subsidies, insurance mandates, even a proposal to extend subsidized insurance to illegal immigrants. It’s an important reminder, first that the left will always want more government intrusion in health care, and second that conservatives can never hope to outspend the left by acting as cheap liberals. That’s why it’s so important for our party to outline a conservative — repeat, conservative — vision for health care.

This post was originally published at Politico.

Gov. Jindal Op-Ed: The Facts about Ebola Funding

Yet another American has contracted Ebola, a grim reminder of just how important it is that our public health systems function at the highest possible level. Unfortunately, much of the rhetoric about this deadly disease is misleading, if not dishonest.

In a paid speech last week, former Secretary of State Hillary Clinton attempted to link spending restraints enacted by Congress—and signed into law by President Obama—to the fight against Ebola. Secretary Clinton claimed that the spending reductions mandated under sequestration “are really beginning to hurt,” citing the fight against Ebola: “The CDC [Centers for Disease Control and Prevention] is another example on the response to Ebola—they’re working heroically, but they don’t have the resources they used to have.”

Consider the Prevention and Public Health Fund, a new series of annual mandatory appropriations created by Obamacare. Over the past five years, the CDC has received just under $3 billion in transfers from the fund. Yet only 6 percent—$180 million—of that $3 billion went toward building epidemiology and laboratory capacity. Especially given the agency’s postwar roots as the Communicable Disease Center, one would think that “ detecting and responding to infectious diseases and other public health threats” warrants a larger funding commitment.

Instead, the Obama administration has focused the CDC on other priorities. While protecting Americans from infectious diseases received only $180 million from the Prevention Fund, the community transformation grant program received nearly three times as much money—$517.3 million over the same five-year period.

The CDC’s website makes clear the objectives of community transformation grants. The program funds neighborhood interventions like “increasing access to healthy foods by supporting local farmers and developing neighborhood grocery stores,” or “promoting improvements in sidewalks and street lighting to make it safe and easy for people to walk and ride bikes.” Bike lanes and farmer’s markets may indeed help a community—but they would do little to combat dangerous diseases like Ebola, SARS or anthrax.

Make no mistake: These types of projects may represent worthwhile endeavors—when funded by states, localities or private charities. And I certainly believe in the goals of wellness as one way to improve health and reduce costs. Here in Louisiana, we’ve launched the Well-Ahead Louisiana program, working with local businesses and organizations on ways to promote healthy lifestyles.

But, as the old saying goes, to govern is to choose. Unfortunately, this administration seems intent on not choosing, instead trying to insinuate Washington into every nook and cranny of our lives. It’s a misguided and dangerous gambit, for two reasons. First, a federal government with nearly $18 trillion in debt has no business spending money on non-essential priorities. Second, a government that attempts to do too much will likely excel at little. And the federal government has one duty above all: To protect the health, safety and well-being of its citizens.

Our Constitution states that the federal government “shall protect each of [the States] against Invasion”—a statement that should apply as much to infectious disease as to foreign powers. So when that same government prioritizes funding for jungle gyms and bike paths over steps to protect our nation from possible pandemics, citizens have every right to question the decisions that got us to this point.

In her speech, Secretary Clinton said, “too often our health care debates are clouded by ideology, rather than illuminated by data.” I couldn’t agree more. But in this case, the data show not that the CDC faced a lack of funding, but misplaced priorities for that funding based on choices made by the Obama administration. I urge Secretary Clinton to put her partisan politics aside, and ensure instead that the federal government focus first and foremost on our most important goal: to keep America, and Americans, safe.
This post was originally published at Politico.

Gov. Jindal Op-Ed: Obamacare’s Failure to Control Costs

When evaluating Obamacare, it’s important to define what “success” means. Success isn’t getting a website to work—even though government auditors recently found that HealthCare.gov still remains subject to lax security controls. And success isn’t forcing people to buy health insurance they might not need or want, under threat of IRS penalty—even though the Obama administration is already working overtime to lower expectations for next year’s enrollment numbers.

No—Obamacare’s prime metric of success, as defined by President Obama himself, should be whether the law reduces health care costs. And on that count, the president could not have been more clear, promising on numerous occasions in 2007 and 2008 that his plan would reduce premium costs for the average family by $2,500 per year. His campaign advisers further told the New York Times that “we think we could get to $2,500 in savings by the end of the first term, or be very close to it.”

A clear definition of Obamacare’s success prior to its enactment allows for an equally clear assessment of the law after its implementation—and on that count, Obamacare has failed miserably. Americans have faced cumulative increases of $6,388 per individual, and $18,610 per family, in higher premium costs because the president failed to achieve the reductions he promised from his health plan.

One year ago this fall, during the HealthCare.gov fiasco, then-Health and Human Services Secretary Kathleen Sebelius famously testified before Congress: “Hold me accountable for the debacle—I’m responsible.” But the real debacle is Obamacare itself: Its mandates, regulations and new government spending have failed to lower health costs, and instead have increased them.

The American people deserve better than Obamacare, and the health care plan I released this spring can provide the relief from rising costs that Americans so desperately need. Rather than focusing on a massive expansion and re-structuring of the health care system, the America Next plan focuses on reducing health costs, using proven methods—competition, more choices for patients, an emphasis on prevention and wellness and no new government mandates—that can lower premiums by thousands of dollars per family.

It’s high time we finally work to enact true health-care reform, one that gives struggling American families relief from rising health costs. That’s the reform President Obama promised, but has singularly failed to deliver.

This post was originally published at Politico.

Gov. Jindal Op-Ed: Another Broken Promise: Obamacare and Abortion

It was bound to happen. After all the secret deals with special interests and Cornhusker Kickbacks used to pass Obamacare, after the extralegal waivers of Obamacare’s new insurance regulations—a majority of which went to participants in union plans—after the multiple delays of an insurance mandate for big business—but not for individuals—you just knew that Planned Parenthood and the pro-abortion lobby would get their political payback for supporting the Democrat machine.

And so it proved. Last week the non-partisan Government Accountability Office (GAO) released a report highlighting all the ways in which the Obama Administration violated the law when it comes to federal funding of abortion coverage on Obamacare’s Exchanges. GAO found that over 1,000 insurance plans provide coverage of abortion procedures—and all of these plans are eligible to receive federal subsidies.

To ram Obamacare through Congress in 2010, the Administration claimed federal funds would not subsidize abortion. While the American people disagree on abortion, the vast majority agree that their tax dollars should not pay for it. Bowing to political pressure, the President agreed to legal language requiring insurers offering abortion coverage to submit a separate charge, and collect a separate premium, for those abortion services.

Ostensibly designed to segregate funds for abortion coverage from federal insurance subsidies, pro-life groups rightly denounced this accounting gimmick as a sham designed solely to give Democrats political cover to support the law. But the Administration has failed to enforce even this accounting gimmick, as GAO found numerous violations of the supposed segregation mechanism.

The GAO investigators found several other legal violations in their report. In five states, all Exchange plans covered abortion services—despite a requirement that the law include a multi-state plan, available in every state, that does not cover abortion. And several insurers had violated the legal requirement to inform consumers that their policies include abortion as a covered benefit. These actions have denied millions of Americans the ability to opt-out of plans to which they have strong moral objections.

Does the Administration care that they’re not following the law? Not in the slightest. But you don’t have to take my word for it. Earlier this month, the IRS Commissioner testified before Congress: “Whenever we can, we follow the law.” I’m not making those words up—that’s what he said.

And that sums up this Administration’s attitude in a nutshell—towards the abortion requirements in the law, and all the other provisions of Obamacare it hasn’t enforced. If it’s politically convenient, the Administration will wield the full power of the state against its opponents—witness the IRS’ illegal, partisan persecution of tea party groups and other conservative organizations. But when it comes to abortion, the Administration won’t even try to obey the law, and compel insurance companies to disclose whether their plans cover abortion or not.

Likewise, President Obama hasn’t bound himself to the promises he made when selling the law in the first place. Remember, the President promised in front of Congress that under his plan, “no federal dollars will be used to fund abortion”—a promise GAO has now exposed as false. What about “If you like your plan, you can keep it?” PolitiFact called it the “Lie of the Year.” And the infamous promise to lower premiums by $2,500? As an analysis released by America Next earlier this summer revealed, that pledge came up short by a mere $1.2 trillion.

On top of all the broken promises we had seen previously, the GAO report revealing just how taxpayer funds have been used to subsidize plans covering abortion provides that much more evidence why Obamacare must be repealed—every single word. And right after doing that, we need to enact a plan that lowers health costs—what President Obama promised to do in the first place—while protecting the sanctity of human life and the freedom of conscience.

This post was originally published at CBN News.