There are now 17 Republican governors who have declined the honor of forming state insurance exchanges to comply with Obamacare rules. The latest three — Kasich of Ohio, Walker of Wisconsin, and LePage of Maine — all realize that their protest is largely symbolic because the federal government will now form the exchanges for them.
In fact, some of the governors will be forming partnerships with the Department of Health and Human Services to run the exchanges.
“Operating a state exchange would not provide the flexibility to meet our state’s unique needs or to protect our state’s taxpayers,” Walker said in a statement.
Kasich’s decision drew quick praise from House Speaker John A. Boehner (R-Ohio). “I’m proud of my governor … for taking a stand and resisting the federal takeover of healthcare in Ohio,” said Boehner, who just last week seemed ready to soften the GOP campaign against the law, pronouncing, “Obamacare is the law of the land.”
Exchanges are designed to allow Americans who don’t get coverage through work to go online to shop for health insurance, like shopping for plane tickets. The insurance will have to meet new minimum standards
States were supposed to open exchanges next fall so people could get insurance starting in January 2014. Ultimately, about 25 million Americans are expected to get insurance on an exchange, according to the nonpartisan Congressional Budget Office.
Most people probably won’t notice a significant difference if their exchange is operated by state or federal officials. But the decision over state exchanges has become a new flash point in the partisan battle over the health law.
States that plan to run their own exchanges are California, Colorado, Connecticut, Hawaii, Iowa, Kentucky, Maryland, Massachusetts, Minnesota, Mississippi, Nevada, New Mexico, New York, Oregon, Rhode Island, Vermont and Washington. All but four have Democratic governors. Several other states, including Illinois, are planning to operate theirs in partnership with the federal government.
Those deferring completely to the federal government are Alabama, Alaska, Georgia, Indiana, Kansas, Louisiana, Maine, Missouri, Nebraska, North Dakota, Ohio, South Carolina, South Dakota, Texas, Virginia, Wisconsin and Wyoming. All but one have GOP governors.
The insurance exchanges will come into existence no matter what. More problematic is the vast expansion of Medicaid that will grant coverage to Americans whose income is as much as 133% over the poverty line ($14,456).
A list of grave problems that will confront states was contained in a letter to the president from GOP governors who have been meeting this week in Las Vegas:
It is clear that putting in place the new programs you championed will be an enormous strain on state governments and budgets, as well as the federal government. From the financial obligations and complex technicalities to ensuring the healthcare workforce and infrastructure will be in place to meet the new demand, the timeframe and many of the provisions in the PPACA are simply unworkable.
A great, big, modern, industrialized state is about to radically overturn its entire health care sector and put in its place…what? Nobody knows. However, it is safe to say that these massive changes will bring total chaos. Millions of people will be overloading the system demanding their “free” health care. The shortage of doctors will mean extended waits for treatment for all but the most dire emergencies. And without massive financial assistance from the federal government, how are states going to fund insurance for their new dependents while paying for schools, roads, police, fire, and everything else they are already responsible for?
The fact that none of this was thought through before Obamacare was passed and that when 2014 rolls around, nobody is going to be ready for the radical changes wrought by the bill, shows the folly engaged in by proponents of Obamacare for ramming it down our throats.