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Wyden Pushing For Oregon Waiver From Health Care Law, Individual Mandate

First Posted: 09/01/10 11:51 AM ET Updated: 05/25/11 06:30 PM ET

Wyden

One of the most innovative voices in the health care debate, Senator Ron Wyden (D-Ore.), is accelerating the process of exempting his state from some of the national reforms passed under President Barack Obama.

The Oregon Democrat is seeking to take advantage of a provision he helped write into the legislation that allows states to set up their own health care systems as long as they meet minimal requirements established by the Department of Health and Human Services. In a letter to the state's Health Authority office, Wyden announced that he will introduce legislation to accelerate the start date for state waivers from 2017 to 2014, if not earlier for Oregon specifically.

In addition, he strongly suggested that the state should use the provision to exempt Oregon from the individual mandate, which would penalize those individuals who refuse to purchase insurance coverage. The mandate was a feature of Wyden's own health care bill but has proved to be remarkably unpopular among voters.

From Wyden's letter (emphasis ours):

As you know, under the Patient Protection and Affordable Care Act (PPACA), I authored section 1332 that makes it possible for Oregon to obtain a Federal waiver and implement its own health care approach without an act of Congress. Oregon has a long history of pursuing flexible strategies for ensuring that all our people have high quality, good value, health care that is affordable to both consumers and taxpayers. Oregonians have demonstrated again and again that a one size fits all approach from Washington is not the best approach for the Northwest, and they have come up with innovative solutions that the Federal government has never had the flexibility or will to implement. For these reasons, I wrote Section 1332 specifically with Oregon in mind.


Section 1332 is scheduled to go into effect in 2017. I intend to introduce legislation shortly to accelerate that date to 2014. Moreover, if the bipartisan legislative leadership and the executive branch were in support, I would like to explore the possibility of Oregon moving forward with a Federal waiver even earlier.

[snip]

In addition, Senate Finance Committee Counsel has stated that a state that can meet the general coverage requirements of the PPACA can obtain a Federal waiver under Section 1332 without a requirement that individuals purchase health insurance. Because you and I believe that the heart of real health reform is affordability and not mandates, I wanted to bring this feature of Section 1332 to the attention of you and the legislature.


wyden1332

In a reply to Wyden, the state's director-designee of the Health Authority, Bruce Goldberg, expressed his openness to allowing Oregon to venture away from the national health care reform package. In particular Goldberg discussed advancing the state's insurance exchange (the veritable marketplace in which businesses and individuals can survey a variety of different plans) beyond the constrictions of Obamacare.

...with insurance exchanges as the centerpiece of national health reform, I believe it would be most beneficial to the nation and Federal agencies for a state of the size and demographics of Oregon to go early with an exchange. This would allow us to test a variety of the systems and policies that will be necessary for national success and for other states to learn from.


wydenreply

The moves by Wyden and Goldberg have potential implications that extend well beyond Oregon's borders. The senator has been a mostly silent critic of parts of the president's health care package, casting a yes vote despite the belief that the legislation did not fundamentally reform the private market. His continued efforts to move his home state into a different system are driven by the belief that the reform passed into law lacked that basic innovation.

Should Wyden prove successful -- both in pushing section 1332's start date to 2014 and in scrapping the individual mandate -- it stands to reason that other states, not all of them as innovative as Oregon, will soon follow. They would, of course, need clearance from the HHS to opt out of the national program. But there's no guarantee that a Democratic administration will be in power at that point.

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One of the most innovative voices in the health care debate, Senator Ron Wyden (D-Ore.), is accelerating the process of exempting his state from some of the national reforms passed under President Bar...
One of the most innovative voices in the health care debate, Senator Ron Wyden (D-Ore.), is accelerating the process of exempting his state from some of the national reforms passed under President Bar...
 
 
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HUFFPOST SUPER USER
Kurt Mundt
Interesting world we live in, eh?
06:07 PM on 09/04/2010
Ron Wyden has bee a good man for Oregon.
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cheo
better a bleeding heart than none at all
06:37 PM on 09/02/2010
Stein is adopting HP's penchant for hyperbole: to cause panic when it's not panic time. I talked to Wyden's office, read the article at http://wonkroom.thinkprogress.org/2010/09/02/wyden-
and re-read this previous HP article: http://www.huffingtonpost.com/2010/03/24/wyden-health-care-lawsuit_n_511748.html
Wyden: Health Care Lawsuits Moot, States Can Opt Out Of Mandate
First Posted: 03-24-10 01:29 PM
What he said in today's article was in the bill when it was passed. To wit:
"Sen. Ron Wyden (D-Ore.) has a message for all [those] who are threatening lawsuits and claiming that an individual mandate for insurance coverage is unconstitutional: You don't have to abide by it -- just set up your own plan.
The Oregon Democrat isn't inviting opponents to defy the newly-enacted health care law. Instead, he's pointing out a provision in the bill that makes moot the argument over the legality of the individual mandate.
It's the "Empowering States to be Innovative" amendment. And it would, quite literally, give states the right to set up their own health care system -- with or without an individual mandate or, with or without a public option -- provided that "they can meet the coverage requirements of the bill."
That language [was] inserted, almost verbatim, into the bill Obama signed into law on
criteria -- particularly on cost containment, improving the delivery system -- they can do it without an individual mandate," the senator said at the time."
10:55 AM on 09/02/2010
How can Wyden say "a one size fits all approach from Washington is not the best approach" but then vote for nothing but one size fits all approaches the whole time he's in the Senate? This is why we have Federalism - let the states decide, and be laboratories for what may or may not succeed. Oregon should be able to do whatever it wants with its healthcare system - the Constitution says so as does common sense.
10:45 AM on 09/02/2010
The problem with the waiver language in the HCR bill is that it doesn't allow states to set up their own system until after they've spent millions setting up exchanges. This forces them to double-pay if they want to cover more people for less money under a single-payer or Medicare buy-in plan.

State exchanges where one or two insurers offer many plans each do not bring real competition and bring costs down anyway. So why force states to waste the money to set them up when the voters are in favor of a MORE robust system than the federal government passed?

Unless you're a health insurer, there's no reason not to let states experiment with a plan that offers more care at less cost. This whole thing was supposed to be about more health care, not more health insurance.
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cheo
better a bleeding heart than none at all
07:08 PM on 09/02/2010
“Senator Wyden wrote the state waiver provision to be purposefully unspecific so that states would be free to innovate new ideas that none of us may have thought of yet,”
Can you tell me where you see this?
"it doesn't allow states to set up their own system until after they've spent millions setting up exchanges. This forces them to double-pay if they want to cover more people for less money under a single-payer or Medicare buy-in plan."
07:15 PM on 09/02/2010
The states are required to set up exchanges before 2014. It would most likely take states over a year to set up an exchange, so they would have to allocate money by 2012 and begin work by 2013 at the latest. They cannot apply for the waiver until after 2014. Even then, the approval process may take years and if the sitting President at that time is anti-reform, they won't get a waiver.

There needs to be a change in the law so that there is time for states to get a waiver before they start work on the exchanges. The timeline is all wrong if they don't want to force states that want waivers to waste money setting up exchanges.
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cheo
better a bleeding heart than none at all
07:13 PM on 09/02/2010
Never mind: the link from Lorraine (below) http://wonkroom.thinkprogress.org/2010/04/27/single-payer-erisa-vermont/ explains what you are talking about....
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HUFFPOST SUPER USER
Salty 2
08:29 AM on 09/02/2010
Here in Fl .
Yesterday my wife got a letter from " Medically Needy" It's a shared cost insurance. Premium went from $268 to $1,071. So much for Obama saying our Healthcare cost would go down. My rates on my insurance went from $300 to $750.
09:09 AM on 09/02/2010
You aren't really surprised this happened are you?
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HUFFPOST SUPER USER
Salty 2
09:14 AM on 09/02/2010
But our wonderful Pres said our cost would go down and there would be more jobs.
02:35 AM on 09/02/2010
Can this Senator really do that?
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HUFFPOST COMMUNITY MODERATOR
OneLiberalLady
Liberals rock!
09:54 AM on 09/02/2010
No, he is merely suggesting that the state take advantage of a provision in the law.
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cheo
better a bleeding heart than none at all
07:10 PM on 09/02/2010
exactly. A provision he wrote and was in bill when passed.
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HUFFPOST PUNDIT
Lorianne
ama vitam
02:02 AM on 09/02/2010
Vermont House Passes Single Payer Bill: Why It Can’t Opt-Out Of Federal Health Reform To Implement It

http://wonkroom.thinkprogress.org/2010/04/27/single-payer-erisa-vermont/
marilyn 63
LEVEL ONE NETWORKER
12:31 AM on 09/02/2010
well Rachel showed where a lot of these rethug politicians screaming about Obama care are now asking for the health care for their states quietly but the press lets them get away with fake outrage!!!
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HUFFPOST SUPER USER
floridafun
Yes We Are!
06:59 AM on 09/02/2010
i saw that too..i am from indiana where a few weeks ago our stoopid gov called unemployment insurance money childs abuse by admin...and fought against healthcare reform. he is one of the governors saying on paper he wants to sue the admin for demanding healthcare, but has in fact requested fed money to implement the next phase LOL..repubs say one thing and do another. just to ginn up their tbaggers LOL!
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HUFFPOST SUPER USER
Kurt Mundt
Interesting world we live in, eh?
06:13 PM on 09/04/2010
It's too bad more don't see that - we'd be less deep in the muck.
11:36 PM on 09/01/2010
Democrat Sen. Ron Wyden of Oregon championed a federal individual health care mandate, wrote it into his own legislation, and voted it into law.Now, he’s not so sure he wants to impose it on his own constituents — and he’s searching for an exemption for his state.

this is rich
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HUFFPOST SUPER USER
Mo Reno
12:16 AM on 09/02/2010
Well if you don't live in Oregon, don't vote for him again. Oregon has an awesome health-care system under OHP. It works fine and will work better when our tax money is returned to us in the form of services we actually need.
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HUFFPOST PUNDIT
tony wise
01:33 AM on 09/02/2010
no ohp does not work fine. it leaves its citizens coverage of healthcare to a LOTTERY based system because they wont fully fund it, choosing instead to fund things like renovations of pge park your way off, i know lots of people who are way under federal poverty level but have NO luck getting on the plan. my wife couldnt get on ot , until she "lucked out" and got pregnant! it took me 2 YEARS to get ANY coverage! and when i did finally get it, it was GREATLY stripped down due to lack of funding.
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HUFFPOST PUNDIT
tony wise
01:34 AM on 09/02/2010
luckily my disability came through the next month lol, so i get medicare now, i pay for it, but its alot better.

saying medicare is better than anything should tell you something.
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cheo
better a bleeding heart than none at all
05:04 PM on 09/02/2010
This man has been my senator for years, and so far I have been proud to vote for him; he is one of the foremost experts on national health care in the Senate. AND he voted for this bill he now wants out of. We all knew it needed work after it got passed and so did Congress, so did he.
But right now, just before an election when people have been swallowing the propaganda from the Right about this administration? This is the right thing to do? The is the right time? Ron, we need to talk.
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Eileen Left
Lifes a bowl of punch, go ahead and spike it
11:35 PM on 09/01/2010
Wouldn't it be great if we lived in a country that based it's health care system on health instead of profit!
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HUFFPOST SUPER USER
floridafun
Yes We Are!
07:00 AM on 09/02/2010
yeah...funny how so many rethugs wanna keep us in the dark ages!
08:46 AM on 09/02/2010
Oh yea, it's the republicans fault. Typical drivel from an ill-informed progressive. Question for you, ever lived in Canada, England as a permanent resident and taken advantage of the system there? Guess what, it isn't all that great. Try waiting a year for an ACL replacement or 6 months to see a specialist (if you can find one).
No system is perfect or great, this administration has taken a system with faults and given us a bigger system with faults. Nothing was done to control costs (which BTW every other country is struggling with), companies now are pushing MORE of the premium cost off to the employee for health plans, individuals still can't pay for insurance with pre-tax dollars and yet fools like you florida blame the republicans. Yea, keep thinking that party line.
10:17 PM on 09/01/2010
I can't wait until we have Kitshaber back as our governor.
01:47 AM on 09/02/2010
True that! F&F.
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HUFFPOST PUNDIT
lizipoo
Sick of sockpuppets
02:06 AM on 09/02/2010
Notice Dudley backed out of the ONPA debate with Mr Kitshaber. Likely Dudley had more pressing biz with his hedge fund clients. His ads are so condescending, I have to hit the mute button every time. "Oregon is not ungovernable????" puh-leeze Dud! The unemployment problem is national, not unique to our State and not the fault of the mostly Dem govt we have proudly elected over the years.

Go Kitshaber!!!!
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HUFFPOST SUPER USER
Kurt Mundt
Interesting world we live in, eh?
06:19 PM on 09/04/2010
We could stand a lot of changes here. Not Dudly's though. Let's get the Doctor back in there.
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HUFFPOST COMMUNITY MODERATOR
Salvador Doggy
hi.
10:13 PM on 09/01/2010
How widely known was this opt-out at the time of the passage of the legislation?

I don't recall hearing about it before.
11:34 PM on 09/01/2010
I read the bill and said all along that the States can make their own decisions. They can set up their own exchanges and still receive the money from the Feds to help as long as they meet basic requirements.

Another GOP scare tactic - acting like the States had no choice.

It's been there all along.

I don't know though whether they can just opt out of the individual mandate - it's my understanding that all individuals still need to be insured.
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HUFFPOST COMMUNITY MODERATOR
OneLiberalLady
Liberals rock!
09:57 AM on 09/02/2010
As to the individual mandate: it's my understanding that there is no meaningful penalty for not being insured, as the enforcement component is non-existent.
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HUFFPOST SUPER USER
Kurt Mundt
Interesting world we live in, eh?
06:21 PM on 09/04/2010
It's the Big Lie theory in action - say something loud enough and long enough and it becomes "true". It's still a lie though.
HUFFPOST PUNDIT
eyeonamerica
09:30 PM on 09/01/2010
SOME STATE SUING FEDS ALSO ARE CLAIMING OBAMA'S HEALTH SUBSIDIES UNDER NEW LAW

Associated Press reports massive hypocrisy of states suing against 'Obamacare' are lining up for
its benefits:

http://www.google.com/hostednews/ap/article/ALeqM5g8ZwV-5Izc-NwpELCsVVD­K9vRWagD9H­UKK9G0
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HUFFPOST SUPER USER
floridafun
Yes We Are!
07:05 AM on 09/02/2010
article not available when i clicked on it..but saw maddow last nite showing govs who are suing to not get coverage..but who requesterd and recieved funding from feds to implement parts of it that are coming into play LOL!
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HUFFPOST SUPER USER
rougebaisers
09:24 PM on 09/01/2010
The dazed and confused dems. So pitiful. They thought they really had something when they passed that crapola. They shall find out how wrong they were in a few weeks.
This user has chosen to opt out of the Badges program
OmaDrei
Family First Forever
11:16 PM on 09/01/2010
rougebaisers,

Wouldn't you like to join your friends Babbling Brooks and Anne from CA? I'm sure they would truly enjoy your company.
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HUFFPOST SUPER USER
Mo Reno
12:18 AM on 09/02/2010
"baiser" is French slang for F&çK, so maybe you'll understand now what S/he is trying to do to your mind.
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HUFFPOST PUNDIT
lizipoo
Sick of sockpuppets
02:08 AM on 09/02/2010
Did you notice all the alterations, deletions and additions of the GOP???? It's a wonder that any of the Dems recognized their original bill after the repug remodeling crew was done with it.
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HUFFPOST PUNDIT
tony wise
08:46 PM on 09/01/2010
oregons system has never beedn sustainable. thats the problem. we face consistent tax hikes on the poorest of us, and consistent cuts in services due to lack of funding.
09:09 PM on 09/01/2010
As the saying goes , "knowledge is power". Get some.
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HUFFPOST PUNDIT
tony wise
09:38 PM on 09/01/2010
and i say the same to you. as an oregonian who can plainly see the healthcare situation we have today, i do not see what you are disagreeing with.
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HUFFPOST SUPER USER
Tom Payned
Card carrying member of ACLU
09:11 PM on 09/01/2010
I'm an Oregonian.

Do you beleive the tax hikes are only on the poorest of us?

We have a small business and voted for M66 & 67 even though it would cost us more money and we don't make much at all. We still have one of the lowest overall tax rates in the nation.

As for cuts, you're right, our system is based on individual income tax rates, & property taxes. Some on Hotel occupancy, but not much more. It's too cyclic, especially in a down economy when people need the social net the most. The Oregon Health Plan being a perfect example.
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HUFFPOST PUNDIT
tony wise
09:35 PM on 09/01/2010
yes , i am an oregonian and in fact was on the oregon health plan. to fund it, there have been several taxes on cigarettes, which is, by definition, the poorest.

66& 67 were specifically for education, not healthcare,. and if you haven't noticed, we are still being threatened with cuts in education despite both new taxes and hundreds of millons of extra stimulus dollars in 2009, over 2008.

im not saying we pay too much taxes, im saying we are using taxes for things like converting pge park to a soccer stadium, while we have an inability to keep the plan fully covered. its not the cost of taxes, its where the taxes go, that keep seeing cuts. we are funding facelifts for trimet, which as you might know, have their own self employment tax, as well as getting money fro every rider, yet, healthcare is not fully funded. why? when we got stimulus dollars, why would we fund a facelift for trimets merlo garage, but not fully fund education with the same stimulus dollars? as you know, it is VERY difficult to get on the oregon health plan. its based on a lottery system atm.

http://en.wikipedia.org/wiki/Oregon_Health_Plan

T