GOP governors walk balance beam on health law
ATLANTA — Florida Gov. Rick Scott, who made a fortune as a health care executive, long opposed President Obama's remake of the health insurance market. After the Democratic president won re-election, the Republican governor softened his tone. He said he wanted to “have a conversation” with the administration about implementing the 2010 law. With a federal deadline approaching, he said that while Florida won't set up an exchange for individuals to buy private insurance policies, the feds can do it.
In New Jersey, Gov. Chris Christie held his cards before saying he won't set up his own exchange, but he's avoided absolute language and said he could change his mind. He's leaving his options open to accept federal money to expand Medicaid insurance for people who aren't covered. The caveat, Christie says, is whether Health Secretary Kathleen Sebelius can “answer my questions” about its operations and expense.
Both Republican governors face re-election in states that Obama won twice, Christie in 2013 and Scott in 2014. And both will encounter well-financed Democrats.
Their apparent struggles on the issue, along with other postures by their GOP colleagues elsewhere, suggest political uncertainty for Republicans as the Affordable Care Act starts to go into effect two years since clearing Congress without a single Republican vote. The risks are acute for governors in Democratic-leaning or swing-voting states or who know their records will be parsed should they seek the presidency in 2016 or beyond.
“It's a tough call for many Republican governors who want to do the best thing for their state but don't want to be seen as advancing an overhaul that many Republicans continue to detest,” said Whit Ayers, a consultant whose clients include Gov. Bill Haslam of Tennessee, a Republican who didn't announce his rejection of a state exchange until days before Sebelius' Dec. 14 deadline.
Indeed, cracks keep growing in the near-unanimous Republican rejection of Obama's health care law. Five GOP-led states — Idaho, Mississippi, Nevada, New Mexico, and Utah — are pressing ahead with state insurance exchanges. Ongoing monitoring by The Associated Press shows that another five Republican-led states are pursuing or seriously considering a partnership with Washington to help run the new markets.
Democrats, meanwhile, hope to use the law and Republican inflexibility to their advantage, betting that more Americans will embrace the law once it expands coverage.
Governors can set up their own exchanges, partner with Sebelius' agency or let the federal government do it. The exchanges are set to open Jan. 1, 2014, allowing individuals and businesses to shop online for individual policies from private insurers.
Low- and middle-income individuals will get federal premium subsidies calculated on a sliding income scale. Eighteen states plus Washington, most led by Democrats, have committed to opening their own exchanges.
Republican Gov. Tom Corbett has said that Pennsylvania will not set up or run an online health insurance marketplace, citing concern over millions in costs and rules that could be placed on the state.
The law also calls for raising the income threshold for Medicaid eligibility to cover people making up to 138 percent of the federal poverty line, or about $15,400 a year for an individual. That could add more than 10 million people, most of them childless adults, to the joint state-federal insurance program for low-income and disabled Americans. Together, the exchanges and the Medicaid expansion are expected to reduce the number of uninsured by about 30 million people within the next decade.
A Supreme Court ruling last summer made the Medicaid expansion voluntary, rather than mandatory for states. At least eight governors, all of them Republicans, have said they have no plans to expand Medicaid.
The complexity is obvious.
National exit polls from last month's election showed that 49 percent of voters wanted some or all of Obama's signature legislative achievement rolled back. Among self-identified independents, that number was 58 percent. Among Republicans, it spiked to 81 percent. When asked about the role of government, half of respondents said the notion that government is doing too much fits their views more closely than the idea that government should do more.
Before the election, a national AP-GfK poll suggested that 63 percent of respondents preferred their states to run insurance exchanges, almost double the 32 percent who wanted the federal government to take that role. And the same electorate that tilts toward repealing some or all of the new law clearly re-elected its champion.
Show commenting policy
TribLive commenting policy
You are solely responsible for your comments and by using TribLive.com you agree to our Terms of Service.
We moderate comments. Our goal is to provide substantive commentary for a general readership. By screening submissions, we provide a space where readers can share intelligent and informed commentary that enhances the quality of our news and information.
While most comments will be posted if they are on-topic and not abusive, moderating decisions are subjective. We will make them as carefully and consistently as we can. Because of the volume of reader comments, we cannot review individual moderation decisions with readers.
We value thoughtful comments representing a range of views that make their point quickly and politely. We make an effort to protect discussions from repeated comments either by the same reader or different readers.
We follow the same standards for taste as the daily newspaper. A few things we won't tolerate: personal attacks, obscenity, vulgarity, profanity (including expletives and letters followed by dashes), commercial promotion, impersonations, incoherence, proselytizing and SHOUTING. Don't include URLs to Web sites.
We do not edit comments. They are either approved or deleted. We reserve the right to edit a comment that is quoted or excerpted in an article. In this case, we may fix spelling and punctuation.
We welcome strong opinions and criticism of our work, but we don't want comments to become bogged down with discussions of our policies and we will moderate accordingly.
We appreciate it when readers and people quoted in articles or blog posts point out errors of fact or emphasis and will investigate all assertions. But these suggestions should be sent via e-mail. To avoid distracting other readers, we won't publish comments that suggest a correction. Instead, corrections will be made in a blog post or in an article.
- Less sleep increases your chance of catching a cold, researchers say
- Supreme Court rules against Kentucky county clerk on gay marriage licenses
- Russia, China ply cyberdata to exploit U.S. spies
- McKinley backers balk over mountain’s name change
- Lost hiker survived 9 days with broken leg in California’s Sierra Nevada
- Suspect in Houston-area deputy’s death has history of mental illness, prosecutors say
- CDC lauds schools for better nutrition
- Thousands in New Orleans became targets of unscrupulous contractors
- Clinton: Women ‘expect’ extremism from terrorists, not GOP candidates
- Virginia reporter, cameraman killed on air; gunman also dies
- Fox News boss says Trump owes anchor apology for latest Twitter attack