Nikki Haley on Health Care



Reject ObamaCare state exchange; reject Medicaid expansion

Those of us who fought the President's disastrous healthcare plan have watched as predictions of lost coverage, rising costs, and unprecedented dysfunction have come true. ObamaCare is damaging to the country, and it is damaging to South Carolina.

But as a state, and as an elected government, we will not be victims in this process. We rejected the federal government's less than generous offer to run a state exchange, an offer that would have Washington bureaucrats dictating the exchange and South Carolinians paying for it.

And, with your help, we emphatically said no to the central component of ObamaCare, the expansion of a broken Medicaid program that is already cannibalizing our budget, and would completely destroy it in the years to come.

These were not decisions made lightly, without thought or analysis. But I am fully convinced that South Carolina will be better for them, and I pledge to you this: we will continue to fight ObamaCare every step of the way.

Source: 2014 South Carolina State of the State Address , Jan 22, 2014

Dead set against ObamaCare: We can't split the cow

The last 3 weeks of the campaign featured a series of knock-down, drag-out debates. I tried to focus on the issues and get Senator Sheneen to explain his support for the Obama health-care plan.

I had pledged, as governor, to lead a coalition of governors to fight Obamacare and allow the states to offer real solutions to our health-care crisis. I was dead set against Obamacare, but Sheheen wanted to have it both ways. Pressed on the issue in the debate, he claimed to support some parts of the Obama plan but not others. There were "good and bad" parts of the bill, he insisted.

"Senator, you can't split the cow," I replied. "You can't say you like certain parts of it and not other parts. We're stuck with the whole cow."

Sheheen's answer was petty and insulting, even for him. "We need a governor with the intelligence and the ability to say when things are good and things are bad," he said. He was calling me unintelligent! The crowd got it and booed the cheap shot.

Source: Can't Is Not an Option, by Gov. Nikki Haley, p.179 , Apr 3, 2012

ObamaCare is wrongheaded and unconstitutional

We have a president and a Washington crowd that think they know better than we do. Not only that, but they think there's a one-size-fits-all answer to all our problems, as if South Carolina were the same as California or Michigan.

I have been consistent as a candidate and as governor in my position to Obamacare. The president's approach is wrongheaded and unconstitutional. He's pouring more costs into the system through federal mandates instead of taking costs out of the system through transparency and individual responsibility.

But there is one bright side to the president's plan: It has sparked a conversation about health care that is badly needed. Our healthcare problem is real. In South Carolina we have a large Medicaid population, and health care is the main driver of our budget deficit. But our health-care problem is also unique to our state--it's not the same as the health-care challenges in states like MA or NE. Our challenges are mainly poverty and education.

Source: Can't Is Not an Option, by Gov. Nikki Haley, p.205-206 , Apr 3, 2012

ObamaCare opt-out rules disallow state opt-out

In South Carolina we have a large Medicaid population, and health care is the main driver of our budget deficit. But our health-care problem is also unique to our state--it's not the same as the health-care challenges in states like Massachusetts or Nebraska. Our challenges are mainly poverty and education.

We have good services, but we need to educate people on how to better utilize them and on how to pay more attention to their health.

I told Obama that his health-care plan imposed mandates that South Carolina just couldn't afford. Our annual budget is $5 billion, and we had calculated that his plan would cost us $5 billion over the next 10 years. We expected to see 30% to 40% of our private companies drop their employees' coverage and force their workers into the public system. My question had 2 parts, I told the president. Would he repeal Obamacare? And if not, would he allow South Carolina to opt out of the system?

Source: Can't Is Not an Option, by Gov. Nikki Haley, p.206-207 , Apr 3, 2012

Medicaid is a broken system; federal mandates cause problems

Our number one health care problem in this country was its high cost--the way to provide better health to our citizens was not just massively expanding a broken system by giving it more government money. Medicaid is that broken system--there is too much waste, too much fraud, and too little focus on prevention and personal responsibility. And almost all of those problems are caused by the mandates of the federal government. But here in South Carolina, we are tackling the root causes of our problems, not just the symptoms. We are shifting towards Medicaid managed care, which saves us money and delivers better quality than traditional Medicaid. And we are giving managed care companies a financial stake in improving quality year after year. No longer will S.C. bear the costs of poorly managed health care alone. We will continue to push back against the federal takeover of our health care system. South Carolina does not want, and cannot afford, the President's health care plan. Not now, and not ever.
Source: 2012 S.C. State of the State Address , Jan 18, 2012

No government-run health exchanges; transparency instead

South Carolina does not want, and cannot afford, the President's health care plan. Not now, and not ever. To that end, we will not pursue the type of government-run health exchanges being forced on us by Washington. Despite the rose-colored rhetoric coming out of D.C., these exchanges are nothing more than a way to make the state do the federal government's bidding in spending massive amounts of taxpayer dollars on insurance subsidies that we can't afford. We will have no part in that. Instead, we will continue to fight to increase transparency between patients and doctors and doctors and insurance companies and to get South Carolinians invested again in their health care . As a nation, we can no longer allow ourselves to be divorced from the true cost of our health care--and in South Carolina, we won't be.
Source: 2012 S.C. State of the State Address , Jan 18, 2012

Let Medicaid buy generics for AIDS, cancer, & mental health

The majority of prescription drugs issued by Medicaid are generic, with three large exceptions: AIDS, cancer, and mental health. We propose that we remove the proviso prohibiting the use of generic medications to treat those three afflictions. I realize that this may sting pharmaceutical companies, and some lobbyists, but it is an option that will allow us to realize real savings without compromising the quality of care for our patients.

I ask that we strike the proviso prohibiting the HHS Director from setting rates paid to providers through Medicaid. South Carolina is the only state in the nation that doesn't give our Medicaid director that flexibility, and with all due respect, we can't be the only state that has it right.

Source: 2011 South Carolina State of the State Address , Jan 19, 2011

Cap punitive damages to limit medical costs

Frivolous lawsuits and out-of-control punitive damages drive up the cost of doing business and drive down the quality of healthcare in South Carolina. Our legal system must be reformed to include mandatory, non-binding arbitration and a "loser pays" component to all medical malpractice suits. Most importantly, we must institute a cap on the amount of non-medical damages that can be awarded in a lawsuit. Again, Texas has made strides following tort reform efforts, with studies showing 5.3% economic growth attributable to these reforms. As an added benefit, there has been greater access to care as doctors in high-risk specialties, like obstetrics-gynecology and neurosurgery, have relocated to Texas to take advantage of the improved legal environment.
Source: 2010 Gubernatorial campaign website, nikkihaley.com "Issues" , Nov 2, 2010

Loosen "one-size-fits-all" approach to Medicaid.

Haley signed Letter to Pres. Obama from 32 Governors

As Governors, we are writing to you regarding the excessive constraints placed on us by healthcare-related federal mandates. One of our biggest concerns continues to be the Maintenance of Effort (MOE) provisions of the Patient Protection and Affordable Care Act, which prevent states from managing their Medicaid programs for their unique Medicaid populations. We ask for your immediate action to remove these MOE requirements so that states are once again granted the flexibility to control their program costs and make necessary budget decisions.

Every Governor, Republican and Democrat, will face unprecedented budget challenges in the coming months. Efforts to regulate state operations impose greater uncertainty on our budgets for oncoming years and create a perfect storm when coupled with the current state of the economy.

Health and education are the primary cost drivers for most state budgets. Medicaid enrollment is up. Revenues are down. States are unable to afford the current Medicaid program, yet our hands are tied by the MOE requirements. The effect of the federal requirements is unconscionable; the federal requirements force Governors to cut other critical state programs, such as education, in order to fund a "one-size-fits-all" approach to Medicaid. Again, we ask you to lift the MOE requirements so that states may make difficult budget decisions in ways that reflect the needs of their residents.

Source: Letter to Obama from 32 Governors 110107-Gov on Jan 7, 2011

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