Some Republican Governors Coming On Board the ACA

Two Republican governors, while reiterating their opposition to federal health reform, have announced their states will move forward. Idaho Governor Butch Otter said his state will submit plans to the federal government for a state-run state health insurance exchange. The deadline for states is the end of this week. Gov. Brian Sandoval of Nevada announced his state would take up the option to expand Medicaid eligibility.

"There will be a health insurance exchange in Idaho," Otter was quoted by the Idaho Statesman. "Our options have come down to this: Do nothing and be at the federal government's mercy in how that exchange is designed and run, or take a seat at the table and play the cards we've been dealt. I cannot willingly surrender a role for Idaho." Otter adopted the recommendation of a panel he appointed to study the issue. In his Dec. 11 press release, Otter made it clear that he does not support the Affordable Care Act. “This decision does not signal support for the law or how it is being implemented.”

Meanwhile Nevada Governor Brian Sandoval told the Associated Press that he would support the expansion of Medicaid eligibility to 138 percent of the federal poverty level, adding 78,000 residents to the state insurance program. Nevada’s current eligibility is set at 87 percent of FPL. The governor said costs would be offset by $16 million savings to the state’s mental health programs. The AP reports “The first-term Republican governor said while he opposed the health care law, his decision will help tens of thousands of people.”

In Florida, Gov. Rick Scott, a vocal critic of the ACA, is reportedly exploring his next move after the Obama administration made it clear this week that states had to fully expand their eligibility (to 138 percent of FPL) in order to qualify for federal matching funds, which for the first three years cover all the costs for those new eligible up to 138 percent of FPL. The media also reports that Scott may be moderating his opposition to operating a state-run insurance exchange. He says he wants to talk to Secretary Sebelius about it.  

Other governors remain steadfast in their opposition  to the ACA and their refusal to take state action. Georgia Gov. Nathan Deal and Alabama Gov. Bentley have recently reiterated their positions according to press reports.

On the other hand, Arkansas Gov. Beebe is taking his recommendation on eligibility expansion to the 2013 legislature. Mississippii’s legislature has begun to debate expansion. A new poll in Missouri shows citizens support Gov. Jay Nixon’s position to expand Medicaid although Republican legislative leaders have largely balked at the proposal.

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