Republican gubernatorial administrations in Ohio, Indiana and Wisconsin will announce plans today for insurance exchanges in their states mandated by "Obamacare," and by all indications they will leave the responsibility for establishing the exchanges up to the federal government.
Govs. John Kasich of Ohio and Scott Walker of Wisconsin have hinted strongly that they will forgo the opportunity to establish and operate a state-based exchange. Indiana Gov.-elect Mike Pence said his state will decline a state-based exchange today.
Kasich's staff already has drafted a letter that it will send today to the Obama administration, and aides to Kasich said not to expect surprises in the letter.Today had been the deadline for states to notify the U.S. Department of Health and Human Services of their plans. However, Secretary Kathleen Sebelius yesterday pushed back the deadline until Dec. 14.But what could be viewed as a final repudiation of President Barack Obama's Affordable Care Act -- Kasich, Walker and Republican governors across the country have fought the law -- is being portrayed in Las Vegas as a signal that GOP-controlled states are beginning to operate in the reality that Obama will be the president for the next four years.
During two days of meetings and news conferences at the Republican Governors Association's annual conference, Kasich and his colleagues acknowledged that Obama's re-election last week cemented his health-care package as law.
Kasich said he's trying to lead an effort among GOP governors to compromise with Obama on Medicaid expansion, a component of the law, while at the same time he and his colleagues cling to the GOP policies that were center stage during the election.
"We will work with the president where our ideas can overlap, and we will make a good-faith effort in all respects to do that," said Gov. Bob McDonnell of Virginia, whose last day as chairman of the Republican governors group was yesterday. The event was at the Encore casino and resort.
"But where there are unfunded mandates on the states or where there is a trampling on the 10th A mendment or undermining of federalism that hurts the states, we'll fight him," McDonnell said.On insurance exchanges, McDonnell pointed out that states were given the option of operating one, partnering with the federal government or leaving it to the feds to establish exchanges in their states.
"I think most governors here at this conference would instinctively prefer to choose state versus federal," Walker said. "The concern I have is, they're really state (run) in name only."
The Kasich administration has made similar arguments, and this week Kasich said, "I don't know why I would want to spend Ohioans' money on something I can't determine."
The U.S. Supreme Court overturned the planned Medicaid expansion requirement of the Obama plan this year, and Kasich said Medicaid eligibility is one area where the governors could seek compromise with Obama. He floated lowering the threshold from 138 percent of the poverty level to 100 percent as an option for states to agree to expand the program. "That seems pretty reasonable," Kasich said. "We have to get a lot more flexibility from the administration, from the White House, if you're going to do things like this."
Kasich pleaded for both Democrats and Republicans to take care as they seek agreement to avoid the "fiscal cliff" of automatic tax increases and spending reductions, asking them to consider that "if you do not act in a fair-minded way, you could really damage states."
Kasich also reaffirmed his position that raising tax rates on high-earners would harm business growth -- clearly opposite of Obama's position. And the tax plan he likely will propose in his budget next year -- lower tax rates and elimination of deductions and loopholes -- sounds in theory much like the plan Republican nominee Mitt Romney put forth."Any similarity in the rhetoric between what we want to do and what was in the campaign is purely coincidental," Kasich said. "Our income-tax rates are too high and are definitely a problem for small business."
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