For some GOP governors, embracing Obamacare is smart politics

10/28/2013 1:59 PM

11/05/2013 6:27 PM

While we’re waiting for the Obamacare health exchange website to reboot, let’s take a look around at what else is going on with the Affordable Care Act.

• Ohio’s staunchly Republican governor used an obscure legislative panel to conduct

an end run around his GOP-controlled legislature last week and accept $2.5 billion in federal funds to expand the state’s Medicaid program. Not surprisingly, six conservative lawmakers have gone to court

, contending John Kasich’s maneuver was illegal.

Obviously, Kasich thought the advantages of Medicaid expansion outweighed the risks. The governor says he’s still an opponent of Obamacare, but that making health insurance available to 275,000 poor people makes sense for humanitarian and economic reasons. We can assume it also makes sense for political reasons. Kasich is running for re-election next year in a state that voted for President Barack Obama in 2012.

• Iowa, one of several states to set up a partnership with the federal government to run an insurance exchange,

announced

it would be cutting the cord and transitioning to an independent state-operated marketplace by 2016. Good move, Iowa. Obviously, running your own exchange is the best way for states to avoid the problems we’re seeing with HealthCare.gov, the federal marketplace. Iowa’s governor, Terry Branstad, is a Republican.

• Tom Corbett, another conservative Republican governor in a blue-leaning state, has been pushing his “Healthy Pennsylvania” plan, which proposes to accept the federal Medicaid expansion money and use it to help low-income Pennsylvanians purchase health insurance on the exchange.

Corbett, who is looking at a tough re-election bid next year, is

cloaking

his proposal in Republican garb, changing some existing Medicaid requirements and proposing a job-training component for recipients. But he apparently has made the calculation that leaving billions of dollars of federal money on the table and denying a chance at health insurance to 500,000 people aren’t great moves for his political future.

Hello, Kansas and Missouri. Are you listening? While GOP politicians, who never wanted the Affordable Care Act to succeed, are feigning outrage over the insurance exchange’s technical difficulties, some of them are moving mountains to ensure their states’ participation in Obamacare.

Though the tea party will never stop resisting the Affordable Care Act, most politicians understand it isn’t going away. The problems with the exchange, though horrendous and embarrassing, will be fixed. People will sign up for insurance. States with sensible governors and legislatures will use federal Medicaid money to realize a vast drop in their numbers of uninsured residents. More states will recognize that it makes sense to run their own insurance exchanges.

Sooner or later, citizens in deep-red states like Kansas and Missouri are going to start wondering why insurance policies cost more on their exchanges than in states that worked cooperatively with insurance companies to set up their own marketplaces. They’re going to question the injustice of leaving hundreds of thousands of low-income people exposed to poor health and financial ruin because they have no way to purchase insurance, while citizens of states with smarter politicians finally have coverage.

Republican politicians in safe districts may be OK. But continued resistance to insurance exchanges and especially Medicaid expansion could start to become a problem for Republicans with designs on statewide offices. They need to look like the world’s biggest Obamacare haters to win GOP primaries. But that stance won’t play well with the broader electorate for much longer.

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