Here is my Sunday column …

Conservative Republicans and tea party types, eager to the very end to repel
Obamacare, celebrated this week’s legislative defeat of a plan to establish a
health care exchange – the Affordable Care Act’s “marketplace” – in Michigan.

What these diehards fail to understand, in their zeal to hold Obamacare at
bay, is that they have undercut the most conservative aspect of the ACA.

As these purists mounted the barricades, all they accomplished is to impart
self-inflicted wounds on the state of Michigan.

The online exchanges are an idea borne more than 20 years ago within
conservative think tanks, such as the Heritage Foundation, to create a
marketplace where the uninsured could shop for health care coverage offered by
various private insurers.

The concept was this: Rather than the government establishing a bureaucracy
to provide medical services for our nation’s shamefully high number of
uninsured, let the private sector handle the problem.

Make the insurers compete for that huge pool of millions of new customers
and give the uninsured tax breaks to help them afford their individual
policies.

If that’s not a conservative approach to the problem, what is?

Yet, Michigan’s
anti-Obama zealots dug in their heels and the GOP-controlled House Health
Policy Committee this past week flat-lined the bill that would have established
a state exchange.

The result? The state will still have an exchange, but it will consist of a
cookie-cutter version spawned by the feds that will grant Michigan less flexibility to customize their
online marketplace to address the state’s needs and dynamics.

Is that a victory worth celebrating?

Consider this: The losers in this political battle were insurance companies,
much of the business community and Gov. Snyder, all of whom had advocated for a
system designed by our home state.

Michigan
is certainly not alone in this last-ditch revolt against Obamacare. One
estimate indicates that as many as 30 states will foolishly follow the same
path.

It’s important to note that the defeat in the Michigan House came just days
after the federal Department of Health and Human Services issued new ACA rules
that grant the states more maneuverability than expected to tailor their state
exchanges.

Families USA,
a nonprofit group that advocates for consumer-friendly health care reforms,
expressed dismay that the state Legislature “walked away” from the chance to
create a Michigan-made exchange.

“This was a wonderful opportunity for your state to take advantage of an
exchange. We don’t understand why Michigan
would reject funding to develop something that meets their needs,” said Claire
McAndrew, a senior health policy analyst for Families USA.

Under the exchange system, each consumer will choose from price-adjusted
health plans available in four categories, ranging from the bronze tier, which
requires the insured to pay 40 percent of annual health care costs in
deductibles and co-pays, up through silver and gold categories and topping out
at the platinum level, where the policy holder pays higher premiums but just 10
percent of out-of-pocket costs.

Contrary to tea party propaganda, this is not free health care. The
means-tested federal tax subsidies simply ensure that no uninsured household
pays an exorbitant amount for insurance.

Open enrollment will begin on Oct. 1, 2013, and the exchanges will power up
on Jan. 1, 2014.

Gov. Snyder has rightly compared the exchange process to the Travelocity
website that gives travelers numerous options when planning a trip.

Overall, the marketplace exchanges, the centerpiece of the entire reform
plan, are based on the system offered to federal employees – from White House
janitors to senators – that allows them to shop for a policy that fits their
needs. To view this effective and highly transparent system, go online to the
website opm.gov. Click on “insurance programs” followed by “how do I find a
plan,” stick with the health insurance information, click on “plan comparison
tool” and then present yourself as a hypothetical federal employee.

McAndrew said the ill-informed debate in Michigan relied upon several red
herrings: the exchange does not transform states into a subsidiary of
Obamacare; the 2 to 3 percent assessment levied on each policy will pay for
website operations and state regulators on the lookout for insurance fraud and
scams; the exchange presents no long-term liabilities to the state; and the
process will have no impact on the state budget.

Opponents of a state exchange appealed to politicians’ fears, asserting that
state legislators will become the “fall guys” when Obamacare flops. One woman
who testified at the House committee hearing called the ACA a “horrifying path
to financial ruin” and told the lawmakers, “You will simply be compliant in
implementing the worst law ever.”

Now, Snyder will attempt to repair the damage by piecing together a
“partnership exchange” that allows for a state-fed hybrid. Fortunately, federal
money will still finance the start-up costs.

Meanwhile, those who snuffed out the state exchange need to come to grips
with Obamacare reality – and I’m not referring only to the fact that repeal in
Congress is no longer a viable option.

The ACA is not a government takeover, it is not socialized medicine, it is
not some new welfare program for moochers.

The reform law is multi-layered and complex, so much so that it offers conservatives
several areas in which to propose future amendments, such as the requirement
that all employers with more than 50 employees must offer their workers a
federally certified health insurance plan.

But to take a stand against the most conservative, market-driven aspect of
the ACA is clearly off the mark.

I wonder: If you shoot yourself in the foot, is that covered by Obamacare?