One of Gov. Rick Snyder’s 10 points to “reinvent” Michigan is to move the state to a more “patient-centered model” of delivering health care. But Michigan cannot achieve this goal unless the Patient Protection and Affordability Act is undone. The federal health care law is unpopular, unwieldy, expensive, unconstitutional, and soon to be under attack by a congressional majority committed to repeal.

The good news is that Michigan can play an important role in defeating this top-heavy federal takeover of its residents’ access to health care. The Obama administration expects states to do much of the law’s dirty work, presuming that states will establish “exchanges” to limit the health insurance choices of many of their residents.

The letter of the law prescribes states’ “flexibility” in structuring exchanges, and some believe that it is possible to design an exchange that increases consumer choice. Two states, Massachusetts and Utah, already have exchanges. Pre-Obamacare, exchanges were suggested as a way to get around the major government failure in American health care: Congress’s granting monopoly control of our pre-tax health dollars to our employers, which limits our choices.

Some claim that the Utah Health Exchange is a consumer-friendly model that can blunt the most harmful consequences of nationalized health care. Utah’s exchange, however, has been a disappointment. Although 20 businesses enrolled on the first day of operations in August 2009, only 13 remained enrolled by the end of 2009. As a result, the exchange is being re-launched with new rules in 2011.

Knowing that many states, including Michigan, will be under Republican single-party rule in 2011, certain business interests are making unlikely arguments in favor of Obamacare exchanges. These interests include information technology vendors and consultants, health insurers who believe that they can dominate an exchange to the detriment of smaller competitors, and brokers who hope to get paid by government to serve as “navigators” in the exchanges.

Some lobbyists claim that states can drop out of Medicaid and drive all of their former dependents into exchanges, where they will enjoy budget-busting federal tax credits. Even if this were possible, simply exploiting Obamacare to transfer liabilities to the federal level hardly solves the national challenge of out-of-control health care spending. However, the perverse incentives resulting from such a “reform” would surely dissipate Michigan politicians’ will to undo Obamacare.

Appealing to conservative sentiments, lobbyists also warn that if states don’t establish their own exchanges by January 2013, the federal government will do it for them. This is highly unlikely. Kathleen Sebelius, the U.S. Secretary of Health & Human Services, has already missed many deadlines demanded by the legislation. In January, the new Congress will take away her checkbook, further diminishing her ability to roll out Obamacare.

The greater risk is that Michigan would establish an exchange that it believes blunts the worst effects of the federal takeover. Given its unpopularity, Secretary Sebelius is likely to approve exchanges for the short term, making Obamacare appear less harmful than it really is. However, if advocates of repeal fail over the next two years, Sebelius will surely sweep away any “consumer-friendly” accommodations with a vengeance. President Obama and Sebelius want to eliminate all private choice of health care in favor of a government monopoly. Once the exchanges are up and running, the administration will be able to impose whatever arbitrary regulations it wants.

Michigan would also find that an exchange is very expensive to operate. Massachusetts’ Commonwealth Connector spent more than $26 million on vendors and contractors in 2009, and $3.4 million on employee compensation. This comprises fully 3.5 percent of the money that businesses and enrollees paid into the exchange.

Any state establishing an exchange is making a one-way, lose-lose bet. If Obamacare persists, exchanges will become bloated administrative nightmares. If it is defeated, states will have wasted time and energy that should have been directed toward that effort. Obamacare is the president’s problem. Don’t make ?it Michigan’s, too.

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John R. Graham is director of Health Care Studies at the Pacific Research Institute and an adjunct scholar with the Mackinac Center for Public Policy, a research and educational institute headquartered in Midland, Mich. Permission to reprint in whole or in part is hereby granted, provided that the author and the Center are properly cited.

The U.S. Environmental Protection Agency has declared a war on America’s primary sources of energy — particularly coal. The foot soldiers in this war are a bevy of proposed EPA regulations that will drive up the cost of the conventional fuel sources that Americans use to power their factories and heat their homes. Worse, these changes will threaten the reliability of the U.S. power grid, which is essential to our modern way of life.

The EPA’s proposed rulemaking is no longer an interpretation of existing law, but instead has morphed into lawmaking. The previous Congress declined to pass cap-and-trade legislation that would limit total greenhouse gas emissions, probably because they recognized that a de facto energy tax on American consumers and businesses would seriously damage an already anemic economic recovery. Undeterred, President Barack Obama is making good on his threat to use EPA regulations to limit energy production and use.

EPA’s war on energy is a coordinated attack on several fronts:

• Regulation of CO2 under the Clean Air Act. The EPA is proposing to regulate carbon dioxide emissions from factories and commercial establishments across the nation. The agency has issued a “tailoring rule” — government-speak for making up the law as you go — that would add CO2 to the list of criteria air pollutants. The rule also sets an arbitrary threshold of 75,000 tons of carbon dioxide equivalent emissions per year, even though the Clean Air Act sets the threshold of 100 to 250 tons per year. The agency wanted to avoid having to monitor hundreds of thousands of additional sources, so it made up this new threshold. Still, it is estimated that thousands of new sources will for the first time be required to obtain time consuming and costly Clean Air Act permits.

• Classifying coal fly ash as a hazardous waste. Coal fly ash is a byproduct of burning coal to produce electricity. Coal fly ash is regulated by state environmental agencies as a nonhazardous waste and is recycled into many products, including asphalt. Requiring coal fly ash to be treated as a hazardous waste would make many coal-burning utilities uneconomical and result in their closure.
• New stricter standards for ozone. The EPA is proposing to lower ozone (smog) standards to levels between 60 and 70 parts per billion — the third time the standard has been lowered during the past 15 years. A standard of 60 parts per billion would be so strict that it would approach background levels in many urban areas and result in much of the country being out of compliance. This would be a costly and gratuitous outcome.
• New industrial boiler rule. This rule will subject thousands of industrial, commercial and institutional boilers to much stricter air quality standards. The rule is structured to have the most impact on coal and biomass boilers. Operators will be faced with very expensive pollution control upgrades or, more likely, a switch to natural gas boilers which emit fewer greenhouse gases but are more expensive to operate.

Any one of these proposed EPA rulemakings would have a significant impact on the cost of energy in the United States. Taken together, they represent an all-out assault on energy production and use. A common thread that runs through the proposed EPA rules is to make it prohibitively expensive to use coal to produce electricity and power industry. 

Coal still powers much of the electric grid in the country. Wind and solar energy are not reliable enough (the wind does not always blow and the sun does not always shine) to replace coal without seriously jeopardizing electric reliability. 

It is critical that the new Congress stop the EPA’s attempts to dictate energy policy by administrative fiat. State governors should prepare to rebuff the EPA’s abuse of power by instructing state environmental officials not to implement the new regulations if they are promulgated. This “regulation without representation” is an arrogant abuse of power and is a clear attempt by EPA officials to thwart the will of Congress — and of the American people.

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Russ Harding is senior environmental analyst at the Mackinac Center for Public Policy, a research and educational institute headquartered in Midland, Mich. Permission to reprint in whole or in part is hereby granted, provided that the author and the Center are properly cited.