Nothing short of repeal will save the states

Gov. Nathan Deal Contributor
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I wear with pride my bruises and scars from the fight against passage of Obamacare in the U.S. House. In 2009, I was the ranking Republican on the Energy and Commerce Subcommittee on Health, and I was the first congressman to say on the floor that the individual mandate was unconstitutional.

Now that I’m governor of Georgia and facing mandates with crippling price tags for my state’s taxpayers, I’m seeing firsthand the job-destroying effects of the federal government’s overreach. No one would confuse me for an advocate of the law.

So it’s no surprise that I fully support congressional Republicans’ efforts to repeal Obamacare. But with that effort stalled in the Democratic Senate, some of my House GOP friends have discussed simply cutting off the money for its implementation. While I share their concerns about the disastrous effect Obamacare will have on our economy and personal freedoms, Washington cannot simply defund it without rescinding its crippling mandates. Otherwise, these mandates will be passed on to the states to become the most burdensome, suffocating taxes on the American public in the history of this country. Unlike the federal government, states are unable to print greenbacks or borrow money from the Chinese government to cover deficits. Most states, including mine, require balanced budgets.

The costs associated with implementation are enormous and difficult to gauge. The only way we can calculate the cost is to examine the requirements of the law and then look at how the federal and state governments are expected to divide the costs.

If federal taxes were raised to cover the true costs of new healthcare spending — one estimate has it at more than $82 billion — Georgians’ federal tax obligations would rise $2 billion a year. That’s $200 for every man, woman and child in the state (meaning the bill is actually much higher for the people who actually pay income taxes).

Georgians would see their state tax burdens rise significantly as well. Georgia taxpayers would have to fork over, at a minimum, an additional $465 million per year to pay for a dramatic expansion of our state Medicaid program that is required by the new law. For Georgia families, this translates to an annual increase of approximately $1,000 per household. With so many families struggling to make ends meet, these extra costs would be nothing short of debilitating.

To cover some of the costs of Medicaid expansion and the mandated insurance exchange, Obamacare reduces the rate of reimbursement to doctors and other providers significantly. This reduction in reimbursement may affect the number of doctors who accept Medicaid patients, seriously impacting patient access at a time when demand will skyrocket. In fact, the estimated 1.2 million Georgians who will become covered through Medicaid and insurance exchanges have been projected to generate an additional 1.2 to 2 million physicians visits per year. This translates into a shortfall of 300-400 providers in Georgia.

Not only will costs rise for individuals, families and physicians, but the State Health Benefit Plan will also take a hit. Because the health care law requires employers to cover dependents up to age 26, the state and its employees will share a 12 percent cost increase. Other mandates, such as having to re-insure retirees until they reach Medicare age, will put tens of millions of dollars of new costs on the state as an employer.

Republicans in Washington must remember that their constituents are not only federal taxpayers but also state taxpayers. Defunding Obamacare doesn’t stop the mandates — it simply makes them unfunded mandates passed along to the states.

Georgia can’t afford the costs of Obamacare even with the federal government paying its share, much less paying the full costs.

I want congressional Republicans to continue fighting to repeal Obamacare. But until that happens, Washington can’t leave states bearing the crippling costs of a program we never wanted to begin with.

Nathan Deal is the governor of Georgia. As a member of the U.S. House, he served as chair and ranking Republican on the Health Subcommittee of Energy and Commerce.