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Monday, December 09, 2019 {{ new Date().getDay() }}

It doesn’t make any sense. Republican governors who despise federal government overreach are refusing to set up their own state health care exchanges, which means the federal government will come in to set up their exchange.

Do they hate Obamacare so much that they’re sitting on their hands and holding their breath till it goes away? Maybe. But there is some strategy behind it.

Many governors were waiting for the outcome of the election in hopes that Mitt Romney would win and grant them a waiver from the law. Now that that dream is over, the Republican governor of Mississippi has opted to create his own exchange and Florida’s governor Rick Scott is negotiating with the federal government about his state’s Obamacare implementation.

But Republican governors Scott Walker of Wisconsin and John Kasich of Ohio are two of  the more than a dozen states who are forcing the feds to come in and do their job. And Tea Party activists are still pressuring Republican governors to not set up the exchanges, threatening primary challenges to those who do.

The first strategic motivation could be to simply overwhelm the federal government with so much work that it can’t properly implement the exchanges in their states. The Department of Health and Human Services already extended the deadline for governors to decide if they want to set up their own exchanges from mid-November to mid-December.

But the second motivation is more typical of the paranoid style that’s come to drive the Republican Party. They believe they can get out of the law if they wait and let the federal government set up the exchange due to a lawsuit filed by Oklahoma’s attorney general that suggests that the premium supports that make up the law would only be available in the state exchanges. If the case wins, the federally set up exchanges would crumble.

“No one would go to those exchanges. The whole structure created by the health care reform law starts to fall apart,” said Gretchen Young, senior vice president-health policy at the ERISA Industry Committee in Washington.

Does this fantasy have any merit after the contentious battle that saw Bush-appointed Chief Justice John Roberts uphold the law while passing the issue of Medicare expansion down to the states? Maybe. But unlike the original case, Republicans attorneys general from around the nation haven’t joined the suit.

Thus we get to the third motivation, Republicans—especially those with national ambitions–are just trying to keep the smell of Obamacare off them, knowing it would be lethal to them in a primary.

The right is so anti-Obamacare, they’re even willing to necessitate a slight version of the one thing they say they oppose most: a federal government takeover of health care.


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