Republican Governors Try Blocking Health Care For Their Citizens In States The GOP Controls

Earlier this month Maine voters signaled they had had enough of the GOP-teababgger experiment in their state. They gave Obama a 56-41% advantage, reelected both Democrats to Congress, progressive Chellie Pingree with 65% and Blue Dog Mike Michaud with 58%. Mainers also voted for marriage equality 53-47%. And the voters booted enough Republicans out of the state legislature to give the Democrats back majorities in both the House (86 Democrats, 60 Republicans 3 Independents, 2 not yet called) and Senate (19 Democrats, 15 Republicans, 1 Independent). Did Maine's renegade Tea Party governor, Tom LePage, learn anything useful from this? Of course not. LePage glories in being an obstinate moron and takes his daily walking orders and talking points from Hate Talk Radio. This week he responded to Maine's voters by declaring that he would not "lift a finger" to set up Maine's health insurance exchange.

“I’m not lifting a finger,” he said in an interview with Bloomberg at a Republican Governors Association meeting in Las Vegas. “We’re not going to get involved. We’re going to let Mr. Obama do a federal exchange. It’s his bill.”

LePage’s comments came a day before a Friday deadline for states to notify the federal government if they want to run the exchanges themselves.

Described as “Travelocity for health insurance,” the exchanges are websites where small businesses and individuals who aren’t covered through their employer can shop for coverage. Enrollment will begin next October for plans that will take effect Jan. 1, 2014.

Consumers can also use the exchanges to determine if they qualify for subsidies to help pay for their insurance or if they’re eligible for Medicaid, the state-federal health insurance program for the poor.

...States that notify the feds by Friday that they want to run their own exchange have until Dec. 14, under an extension granted this week, to submit a blueprint to the U.S. Department of Health and Human Services. As of Thursday, 16 states were setting up exchanges themselves and 14, including Maine, had decided not to, according to the Kaiser Family Foundation.

Eight states remained undecided late Thursday. Four states planned to partner with the federal government on an exchange. HHS has given states until February to decide if they want to take that path in 2014.

States have been wrestling with how to operate the exchanges since the health reform law was signed in March 2010.

The exchanges will make shopping for health insurance much less complicated, according to Joe Ditre, executive director of Consumers for Affordable Health Care.

“The implications are that for the first time [consumers] will actually have access to a side-by-side, apples-to-apples comparison of each insurance company’s plan,” he said. “That’s huge.”

The federal subsidies will make health insurance more affordable and likely encourage additional insurers to sell competitively priced policies in Maine, he said. But LePage’s choice to forgo a state-run market robbed Maine of an opportunity to negotiate with insurers for the best policy prices through its exchange, Ditre said.

LePage is a clownish figure and an accidental governor who slipped into office in a 3-way race. No one expects him to be reelected. But he's far from alone among Republican governors when it comes to setting up exchanges. As expected radical right Wisconsin Governor Scott Walker made the same decision yesterday, even though his state's voters gave Obama a 53-46% win over Romney and even though Wisconsin voters picked ACA advocate Tammy Baldwin for the open Senate seat over ACA opponent Tommy Thompson, 51.5- 45.9%. In Ohio John Kasich-- also in the wake of an Obama victory in his state and an overwhelming win by ACA advocate Sherrod Brown in the Senate race in which he defeated fanatic health care opponent Josh Mandel, 50.3- 45.1%-- made the same decision yesterday. In an OpEd, the Toledo Blade was very critical of Kasich's bumbling and partisan decision, which endangers the health of millions of Ohioans.

His hopes for repeal of the Affordable Care Act dashed by Mitt Romney’s failed presidential bid, Gov. John Kasich must now enforce the health-care reform law in Ohio. Without enough time to create a state-run health insurance exchange, an active partnership with the federal government would have been the best available option.

Instead, the governor is handing all responsibility for the exchange to Washington. That decision is not in the best interest of Ohio health-care consumers or employers.

Ohio’s Republican leaders could have resolved to determine how best to carry our federally mandated health reform. Instead, they joined other GOP-led states in a failed lawsuit that challenged the constitutionality of the law. President Obama’s re-election quelled their last hope for repeal of the law.

...The reform law requires each state to have an exchange-- essentially an online market where consumers can buy health insurance, compare rates, and learn about and choose coverage levels. If a state chooses not to create its own exchange, the federal government will assume that responsibility.

A state exchange would have given the state greater flexibility and control. It would have been tailored to the specific needs of Ohio’s consumers, health insurers, and businesses.

But Lt. Gov. Mary Taylor, who doubles as state insurance director, said this week that the Kasich administration will “let the federal government run the exchange.” She said a letter from the governor to the U.S. Secretary of Health and Human Services today will make that decision official.

About a dozen states and the District of Columbia have said that they will set up their own exchanges. As many as 17 states are expected to let the federal government run theirs.

The decision against a state exchange left a federal-state partnership as Ohio’s best option. It would have allowed Ohio more control over the things it does that already work and made it easier to make the transition to a state-run exchange in the future. Moving from a one-size-fits-all federal exchange to a state-designed system would be hard and disruptive.

State exchanges also would have given the President’s health-reform law its best chance to succeed. More than 30 million people, including more than 700,000 in Ohio, are expected to gain health coverage under Obamacare.

Most remaining uninsured Americans would be covered by expanding Medicaid, with the federal government footing almost the entire bill. States can opt out of the Medicaid expansion; Mr. Kasich has not said what he plans to do.

Too many governors and legislatures in too many states have been more interested in making sure health-care reform fails than in reducing the number of uninsured Americans, improving the health of the nation, and controlling medical costs. Now it is too late for these states, including Ohio, to take control of their future, unless they have been preparing in secret as they protested in public.

Ms. Taylor insists that she and Mr. Kasich want to work with Congress to “fix” the 2010 law. After two years of foot-dragging and obstructionism, that assertion invites skepticism. Letting the federal government run Ohio’s insurance exchange feels like more of the same.

After complaints from Republican governors (Jindal and McDonnell) about the initial November 16 deadline to decide about setting up state health care exchanges, the Obama administration announced on Thursday that it was extending the deadline for states to decide. These are the governors who have already declared they will not set up health exchanges for their states' citizens:

• Paul LePage, Maine
• Scott Walker, Wisconsin
• John Kasich, Ohio
• Nikki Haley, South Carolina
• Mike Pence, Indiana
• Sam Brownback, Kansas
• Rick Scott, Florida
• Dave Heineman, Nebraska
• Dennis Daugaard, South Dakota
• Nathan Deal, Georgia
• Robert Bentley, Alabama
• Terry Branstad, Iowa
• Sean Parnell, Alaska

Mississippi Governor Phil Bryant has a confused approach no one quite understands but the state Insurance Commissioner, Mike Chaney, is going ahead with plans for an exchange in Mississippi anyway. North Carolina has already started the process by the newly elected hard-right Republican governor, Pat McCroy, says he will look into reversing the process. One quasi-Democratic governor, Jay Nixon (MO), has joined the Republican hardliners against health care. The more mainstream Republicans who are putting politics aside and going forward with exchanges for the good of their states' citizens are Susana Martinez (NM), Bill Haslam (TN), Rick Snyder (MI) and Brian Sandoval (NV). Republican Governors who still haven't announced a decision are several in states Obama won-- Bob McDonnell (VA), Tom Corbett (PA), Chris Christie (NJ)-- and several who would like to do it but are in crazy red states poisoned by Fox News and Hate Talk Radio-- Gary Herbert (UT), Butch Otter (ID), Mary Fallin (OK), and Jack Dalrymple (ND). Arizona Governor Jan Brewer is high on pain killers and unable to focus on the issue.