Chris Christie, New Jersey's Governor, became the latest to opt out of state level health care exchanges required under Obamacare. This is the second time he has vetoed legislation setting up such an exchange that was passed by the Democratic legislature in New Jersey. Fortunately for anyone with commonsense, the New Jersey legislature does not have the requisite votes to over-ride that veto.
There has been a lot written about Christie on these and other pages. The main gist of those articles is that although Christie may be a Republican Governor, he is not someone's ideal Republican, or that he is not conservative enough for some people. There are some things with which I personally disagree with my Governor. For example, his stance on gun control runs counter to my views and my research into the matter. Gun control laws certainly do not decrease the incidences of violent crime and actually only serve to make criminals out of law-abiding gun owners for violations- many times unknowingly- of these stringent laws. But, in context, Christie's background is in law enforcement, specifically prosecution. And in that context, he is expressing the view of most law enforcement officers and organizations. I personally happen to think those views are incorrect, but I am not ready to indict the totality of Chris Christie's conservative credentials based upon this issue.
This decision by Christie to reject a state-run health insurance exchange- a "requirement" under Obamacare- is not even based upon political expediency by Christie. In May, in rejecting the original legislation that would have set up these exchanges, he vetoed the law pending the outcome of the Obamacare cases that were before the Supreme Court at the time. This time, however, his rejection of a modified version of that original legislation is based upon ambiguity in terms of both implementation and cost.
Should a state refuse to set up these exchanges, or opt-out, the federal government will step in and do so. The original law worked under a false assumption that states would simply roll over, accept the legislation, and establish these exchanges. It did not and is not happening as the Administration and Congress, run by Pelosi and Reid at the time, anticipated. Because some conservative, Republican governors and state legislatures stood up against these federally-mandated state-run exchanges, the fiscal folly of Obamacare is exposed.
Simply put, the original legislation and the all the implementation of it- primarily tasked to the Department of Health and Human Services under Kathleen Sebelius- is so ad hoc and confusing that to accept this "mandate" for exchanges blindly is akin to state fiscal suicide. No one knows the true costs of implementation and it is doubtful that taxpayers already under heavy burdens will accept the Democratic mantra that some financial pain now will lead to lower overall health care costs in the future. In fact, people with health care insurance are finding out that since the passage of Obamacare and as some of its provisions have kicked in, their annual premium (whether direct or partial through employer-based plans) have gone up.
Most importantly, when Governors have announced that they are opting out of this requirement, their responses and questions directed towards the bureaucrats in Washington have been met with either a shrug of the shoulders or bureaucratic double-speak. The fact is that Obamacare "assumed" the states would simply accept it. If not, then the federal government was the fall-back. But, the federal government is not equipped bureaucratically or financially to take on this burden. In effect, this aspect of Obamacare was a stealth shifting of the financial burden from the federal government to the states based upon mandates and requirements under a federal law. Without any doubt, had the original law not included an opt-out provision, it would have run into serious constitutional questions of federalism. Thus to get around that scenario, the law gambled and lost thanks to the states that have opted out.
The result, of course, is that the federal government will now step in and establish those exchanges. Again, they never anticipated this level of disagreement, so they are not equipped financially to do so. Money must be found to fund this expensive program and since it will not be forthcoming from the states, the federal government will slap a 3.5% "tax" on insurance premiums sold through these federally set-up exchanges. The insurance companies will simply pass on that tax to purchasers of these premiums. How this somehow lowers the cost of health care insurance and makes it more accessible to people defies logical explanation. For example, had Alabama blindly accepted this idea, it would have cost the state $50 million in implementation costs alone for what would amount to a crap shoot in benefits somewhere down the road. And because the law is so complicated from the start, federal regulations are unspecified and unexplained.
According to the federal guidelines, five broad categories are to be covered under these exchanges: emergency services, hospitalization, maternity and newborn care, preventive services, and prescription drugs. That all sounds well and good, but within all those categories there are many services. Here are two examples. No one doubts that obesity leads to a wide variety of negative health outcomes- diabetes, heart problems, etc. So, should weight loss programs be covered under these exchanges since they are, after all, "preventive?" How about weight loss surgery? That is not only "preventive," but would also fall under the "hospitalization" requirement. In fact, under the proposals in New York and California, weight loss surgery is to be covered, but not in the proposed exchanges in Minnesota or Connecticut. And speaking of Connecticut, infertility interventions were to be covered, but not in other states. Some exchanges specify certain prescription drugs while another state excludes that very same drug.
What does all this have to do with medical marijuana? The same tendency of the heavy hand of the federal government and amorphous non-responses (when responses are even given) is illustrated here with another executive branch department- The Department of Justice. Today, 18 states and DC have approved the "sale" of marijuana for medical purposes. In some states, the prescriptions are restricted to certain medical conditions only. Some states, like California, have rather relaxed laws in this area while New Jersey, which passed a medical marijuana law in 2010, has perhaps the most stringent law. Delaware, which approved it in 2011, basically copied the New Jersey law.
In New Jersey, although I read weekly about regulated and secure grow houses being ready to go and dispensaries readying themselves, medical marijuana is available to any state resident at only one dispensary. This was approved almost three years ago. The fault for the delay lies in Washington. Several attempts- six in all- by Governor Christie to get a straight answer from the Department of Justice, specifically Eric Holder, have been met with non-committal non-answers. How much "looking into" something is required before a straight answer is given? Christie's main concern is if a licensed and regulated dispensary or "grow house" and its employees would be subject to violations of federal drug control laws. It is a simple question that requires a simple answer. But Holder and his Justice Department cannot seem to answer a simple question just as Sebelius and her HHS cannot answer simple questions regarding Obamacare.
In the case of Obamacare, we are talking about a recently enacted and generally misunderstood law even by those who wrote it let alone those who have to implement and administer it. That is to be figured given the fact that it is over 2,000 pages of legalese. But, medical marijuana laws have been around for 16 years now. General statements by Obama, Holder and other federal officials that enforcement against those who seek medical marijuana "not being a priority" does nothing to allay the fears of governors like Chris Christie. Christie's fears are based upon reality.
In Colorado, where medical marijuana has been on the books since 2000, several dispensaries have been forced to shut down based upon their location within 1,000 feet of a school. This was at the insistence of the US Attorney in Colorado, not state or local officials, or zoning officials. Admittedly, the laws are rather lax in California, but here the federal government has been exceptionally aggressive in their efforts against medical marijuana dispensaries. However, the New Jersey law is rather specific and stringent.
Unfortunately, it is statements by legitimate dispensaries in states like Washington that are making it bad for well-intentioned laws. For example, state-licensed dispensaries there lobbied hard against the recently approved referendum regarding the legalized recreational use of marijuana. Their main argument was a drop-off in business. This implied that medical marijuana was being dispensed for recreational use, not its intended purpose. Likewise, California essentially abused its own laws leading to a backlash in many areas. Residents in Los Angeles are vocal that many of the clients of state licensed dispensaries are selling to people who are in no need of marijuana for medicinal purposes. No doubt, there are sleazy doctors and dispensaries out there. But, if the state sets up stringent guidelines and regulates these dispensaries and doctors- as they have in New Jersey- then this should require a clear and concise answer to state requests from the federal government. Yet, none was forthcoming. Since then, only one dispensary has opened in New Jersey in Montclair.
It will be interesting to see how the federal government responds to recently approved referendums in Colorado and Washington. The legalization of marijuana is certainly popular among liberals and liberal groups that recently got Obama reelected. The most logical thing to do would be to amend the Controlled Dangerous Substances Act, a law that dates back to 1912, and afford states leeway under some specific guidelines. That would eliminate the need for letters from governors to the Justice Department. But alas, the Obama Administration, as they have proven in many cases but especially Obamacare, is anything but logical. Their generalized comments about enforcement against medical marijuana laws or their "its not a priority" statements is like their response to state concerns over Obamacare. It is a basic: "Trust us and do this and we will handle any problems as they arise...we promise...maybe." Simply, this is no way to run a government.