Associated Press
Oklahoma Gov. Mary Fallin (R)
Following up on an item from last week, a variety of governors are still making decisions on how (and whether) to create state-based health care exchanges under the Affordable Care Act. States that refuse invite the Obama administration to create exchanges for them.
The latest announcement came from Oklahoma Gov. Mary Fallin (R), who announced yesterday that her state would also refuse to create a health insurance exchange, leaving the job up to federal officials. Oklahoma is now the 17th state to make this decision, and that number may yet grow.
As a rule, when I cover this, I marvel at the irony: many far-right governors who claim to oppose federal control are making a conscious decision to invite more federal control. But let's take the next step and consider why they're doing it.
Some are eyeing higher office and have been warned that cooperating with the Obama administration on health care would ruin their careers. But Jonathan Cohn raises an even more salient point about the larger sabotage strategy.
The subsidies are in the form of tax credits. So Oklahoma officials and everybody else making this argument are essentially calling upon states to block their citizens from receiving federal tax breaks, worth as much as several thousand dollars per person. Aren't conservatives and libertarians supposed to be the party that likes giving tax money back to the people?
Of course, Obamacare critics believe that, by blocking the subsidies, they'll undermine the law's effectiveness and eventually erode support to the point that people clamor for a conservative alternative.
Jonathan Bernstein added, "This is different from typical opposition. It's as if Democrats who opposed missile defense had actively campaigned for contracts to go to the contractors they believed were most likely to produce duds, just so they could eliminate the program after 'proving' that it didn't work.... [O]n health care, it's increasingly hard to believe that they want good outcomes. And that's a lot worse than just typical opposition."
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The dripping irony is not unnoticed!
States' Rights governors? No!
Innovators of needed health care programs at the State level? Nope!
Leaders working in concert with the feds to help make their States' citizens' lives better (as representatives of the Party of Life, what grand irony lost upon their intellects of hypocrisy, ah, but I digress)? Seemingly, not a chance!
Disgruntled tyrant? Well, 17 governors wearing the Republican Brand on their sleeves are making a very good case for such a title!
Having lost in Congress and at the Supreme Court level, these governors are sad sacks begrudging the American people in their efforts to get better health care in the most exceptional nation of the world!
Why do these governors hate America so much?-Kevo
I think the assumption here is wrong. "Conservatives" don't want people in general to get tax breaks or money back. They want the poor to pay more! Making the rich richer, in both absolute and relative terms, is their only goal.
@Kevo - I couldn't agree more!
@IdiotsAndHatersBowDown - Touché! You are exactly right, or shall I say "left". Thumbs up!
It's that GOP Punish Others syndrome. Just like that Denny's franchise owner who told his customers that he was going to levy his own tax on them because of Obamacare, conservatives have no problem bending their principles if it makes them feel superior. That it is a stupid thing to do never enters their minds.
"Aren't conservatives and libertarians supposed to be the party that likes giving tax money back to the people?" - Jonathan Cohn
Umm . . . no. Conservatives and libertarians are the party that likes giving tax money to their multimillionaire patrons and corporate johns.
Tax cuts for everyone else are only acceptable because (1) they make it easier for conservatives to cry "poverty" and cut social programs and (2) because they make it politically possible to pass MORE tax cuts for their multimillionaire patrons and corporate johns.
The more I read, the less hope I have. Is there ANY sanity left in the republican party? As an independent, I'm starting to question my own for all the times I've ever voted republican for anything. Have they always been this crazy and just used to do a better job of hiding it? Cuz, they seem like a bunch of whackos to me right now. Sorry, but that's just what I see right now.
No: http://kfmonkey.blogspot.com/2004/12/i-miss-republicans.html
No, Len, they have not always been crazy. Some earlier Republican presidents supported beneficial policies/laws. For example: Eisenhower--interstate highways; Nixon--environmental laws; and Reagan--Earned Income Tax Credit, which he considered an efficient fiscal stimulus. Back in 1968, Senator Goldwater warned the GOP to avoid using the religious right; he was a fiscal conservative but a social libertarian. The GOP used to be much more varied than today's version. Even the GOP of Reagan's day was much better; but it's been going downhill since (Rove and Norquist got their starts during his administration).
My impression after listening to Thom Hartman's history lessons, but not paying any attention to my Republican parents, is that the Republican Party have always been a bit mean about social programs. For instance, they didn't much like Social Security when it was enacted, (my parents loved it though when they became eligible for its benefit) and consider the State Bank of North Dakota. The progressives tried to get it through in the mid-1930s, which they did, as a matter of fact, but the ND Republican Party were and still are somewhat against it even though it is a great idea and works really well for the folks in ND.
You can go down most of FDR's social programs to Medicare under Lyndon Johnson and they hated and still do hate Medicare even though the people really love it. So, no, in my estimation this current "nuttiness" is coming from the Fox News spin, but the bent to be mean and uncaring is long-term. This is not to say that there are no Republicans who don't support local food banks, their churches, the Salvation Army, the Red Cross, they have some good feelings about helping the poor and helpless, but they don't vote as if they do. And, to an extent, never did.
Regarding the comment above about Nixon supporting the Environmental laws, he was forced to do this. He went kicking and screaming to sign that bill so he himself was very far away from his mother's Society of Friends's teaching of the New Testament.
As to the current state of affairs in the GOP, I would encourage anyone who hasn't seen it to get a copy of Casino Jack and the United States of Money (the documentary, not the Kevin Spacey fictionalized version, which is probably also excellent). Make yourself a big bowl of popcorn and settle in for a very entertaining and enlightening couple of hours.
You'll see the infamous Jack and his buddies Ralph Reed and Grover Norquist as 20-somethings getting their start in influence-peddling during the Reagan years. Also included are extended guest appearances by W, Newt Gingrich, Tom DeLay, Bob Ney and a host of then-current congressmen, all of which illustrates how the modern era of Republican politics is structured. Spoiler alert: Tom DeLay actually believed that you had to have money to play at the top levels of politics and graft was just capitalism in its finest form. Fascinating.
They went crazy after Nixon got caught in the Watergate scandal and had to resign. It all been about getting even with the Democrats for forcing the issue. The monopolies and billionaires that backed him became insecure.
The felt they had to make everything in this nation resolve around them rather than doing what was important to making the nation thrive...strengthening the middle class economic engine. They thought they could outsource it to other countries and it would work as well.
"Greed is Good"became the party's slogan instead of what's good for the country. Ike had already seen it coming with the military industrial complex. But it was Watergate that pushed the John Birchers underground into conservative think tanks where their only agenda was to win elections to protect their interests. The Republic and its needs became secondary.
In many ways the party died with Watergate. There was a hostile takeover by shadowy figures behind the scenes who ran it instead of regular citizens. It became a propaganda based operation. It needed bigots and religious fanatics to give it power. Now only the very rich or the very radical are welcome.
they don't care that this would save their citizens money.
they don't think they deserve healthcare.
after all, they have Emergency Rooms.
They have reduced politics to their own base level of war mongering. They are agin it cause those socialistic libe er fer it. Republicans are no longer in the room. They have moved into the back alley.
These governors have gone completely off of the deep end! Obamacare was modeled after Romneycare - so it was a rethugnikan idea! Aren't the GOP always screaming about "personal responsibility" (whatever that means), tax cuts for "the people", blah, blah, blah! Blatant hypocrisy! The fact is that when the words and actions don't add up - then Houston there is a problem! These "red state" governors - states which suck on the teet of the federal government vs. how much they actually contribute are hurting their own citizens for what, for the hope that the people within the states decide that "Obamacare" doesn't work, really?
Frankly it's the governors themselves that need to be removed from public office because they are doing a dis-service to their constituents! Maybe someone needs to start asking these governors if they plan on turning down the "healthcare" they are provided by their publicly funded jobs, and if they respond with "of course not"; then the next question should be - then why do they feel it's okay for the citizens in their states not to be able to afford health-care thru these exchanges?
Bottom line: they're mortally afraid that they've screwed the pooch on the whole health care thing. Since it's too late to cooperate for the good of the country, they're doubling down on fighting the change to the last officeholder.
They knew that in the long run, the PPACA was going to be as popular as Medicare unless they could sabotage it. They bet on making it so unpopular ("Obamacare," "death panels," etc.) that they could strangle it in the cradle -- and lost. Now calling it "Obamacare" is looking like a permanent reminder of the good stuff that a hated Democrat did for the country.
So, double down: do everything they can to sabotage implementation. And that means a non-trivial chance that, once again, instead of getting some credit with their citizens the whole business turns into a demonstration of the Federal Government doing them a good turn over the strenuous Republican obstruction.
It's like the dude with a straight in stud poker who just keeps raising in the hopes of bluffing the opponent who has him beat on the board.
I'm a little puzzled by how this amounts to sabotage. If the federal government sets up the exchanges in the states that refuse to set them up themselves, on the surface it would seem that this takes those exchanges out of reach of state meddling. So, assuming that I'm missing something, what is is?
Actually, MM, you have a very good point. And since the feds already have a great health program in place, medicare, maybe they will default to that...and then maybe just extend it to all. Hope springs.....
Jonathan Cohn: "Obamacare critics believe that, by blocking the subsidies, they'll undermine the law's effectiveness and eventually erode support to the point that people clamor for a conservative alternative."
Just a friendly reminder that Obamacare is the conservative alternative.
The true progressive alternative for the country is a "Medicare for all", single-payer system.
I would suggest a proposal to make the move to single payer much quicker than the current plan. Currently, it appears there is an unspoken plan, that of forcing employers to pay a fairly small tax if they don't provide healthcare. Effect will be many will stop offering plans and pay the tax. As more do that, the weight, or cost will be significantly more than forecasted.
A solution- calculate the total level of commerce and divide into the total cost of healthcare. A national sales tax at that percentage, and let it be adjusted quarterly. A side benefit is that manufacturing will see huge onshore incentives as the health care cost would go away. Imports would be affected be the sales tax, thus seeing those goods and services contribute to our system instead of getting a free ride. Everyone would pay, those who spend more would pay more by the very concept of sales tax.
I think it's more arrogance than opposition. They thought they had the election in the bag. So, there was no "what if" Obamacare becomes the law. I don't think these Republican Governor's are smart enough to come up with a plan...frankly. I live in a state under Republican rule and it is hell.
I am in Ohio and I wouldn't trust Kasich to come up with a decent exchange anyway. Let the feds do it.
I live in Wisconsinhell,
Is there a chance that the liberals can't see the forest for the trees? Nancy Pelosi was the one who said "We have to pass the bill before we know what's in it." They are just beginning to release the bill and all of its regulations. We are just beginning to find out what is in it. There are some scary details in it that Governors just can't stomach. And we are only BEGINNING to see the effects. Lots ands lots of red tape and things that they can't even understand how to implement. If you allow the Feds to write your plan, then if it is wrong, you won't be held accountable for doing anything wrong. The regulations hold some stiff fines and penalties. I taught special education, and the Feds, in all their wisdom, would hand down regulations with no guidelines or trainings on how to implement them. The ruling would go into effect on a certain date, but when you called to find out how to implement them, the answer would be that the details haven't been worked out yet and sometimes it would be a couple of years. BUT... you were accountable to have all things implemented on that date or face the consequences of being out of step with the law. Typical of Federal regulation. This is how the Feds run every department. I can't get very excited about handing money over to the feds and hope they use it wisely.
But you get excited about handing money over to big insurance companies hoping they use it wisely?
I see your point but it is just common decency to allow people the right to have health insurance and to choose it. But these governors are politicizing a right that citizens should have. After all they have it in all westernized countries. Obamacare is not perfect but it is a start.
All I can see is this: we couldn't win on our ideas, we couldn't suppress the vote, and we probably can't impeach him so we will do everything we can to impede him.
The Bill has been on the Internet for over a year for all to read, they are not just now introducing it...try reading it....but like medicare and social security...it will be a work in progress to iron out all the fine lines....nothing new....
Notwithstanding the silly partisan basis for their opposition to state-established exchanges, these governors are in effect allowing the federal government to create a uniform exchange system over the majority of states. In the end, that may actually be preferable to having 50 different state-based exchanges. So I give an ironic "thank you" to these ostensibly obstructionist governors.
I agree. In a previous post it was said that the Feds would screw it up. But to me it seems that running more exchanges would give the feds a boiler plate to manage the exchanges. I think this would be a better model than having each state wander in and start from scratch.
I keep thinking of the move Mad Max where the elite eventually destroyed the infrastructure and everyone was running around in dune buggies look for gasoline. I the movie Washington D. C. is a wreck and the Hero Mad Max was trying to do something. We can keep voting trying to get these people out of office and maybe we can return to sanity.
Is there any chance of a class action lawsuit across state lines for consumers in those states where the Republican obstructionists are blocking the implementation of the Affordable Health Care Act as it was passed? Seems to me that there may be a price disparity or a delay in availability of the exchange-based insurance if the states are opting out of their own exchanges. Although, I suppose any law suits would only delay things further. Why don't they do what the majority of the electorate has voted for???
Let's let the feds take over all the exchanges and then we'll be on the way to a more efficient system. Single-payer anyone?
Oh I agree! They don't seem to know how to do anything but shoot themselves in the feet!
This is the first step in single-payer healthcare. The more states that ask the federal government to step in, the better the bet that it will become universal. What morons.
We can only hope, Patti. Let's hope it's a BIG step, and that the Dems take control of the House in 2014 so that they can at least create a public option, if not move directly to single payer.
If the legal argument gets tossed then the governors are left with a federal exchange and I am not sure that the state can take over those exchanges. Once the federal framework is in place, the state has lost control of the issue. Even if the state is allowed to take over the exchange, they are not going to be able to change the established rules and practice within the exchange. Any abrupt change is going to disrupt the commercial process and consumers are not going to let any change force them to pay more.
You're just picking up on this now?
These are people with no morals.
These are people that are Anti-American.
These are people that you can safely assume the will do the worst possible thing.
Why hasn't Greg Sargent learned that by now?
And the bigger question - why hasn't Obama learned that by now?
You miss one major point, however. The same states that get more money back in federal spending already are also now insisting that the federal government pay for their share of the ACA. On top of that being fiscally irresponsible - on top of it just not being very neighborly to make every other state in the union pay for your health care system - they're basically asking for yet another hand-out.
It seems that they are hanging their hats on the idea that if the federal government sets up the exchange, then people aren't eligible for the tax breaks. This appears to be a rather weak thread to hang their program on, so if it breaks, as is likely, then they are stuck with a federally devised program. I suspect that if anything goes wrong, they will beat the drum about how government programs never work, but if enough people benefit, then ACA can continue to evolve into eventually a single payer program. I hope so.
http://www.timesdispatch.com/news/state-regional/government-politics/general-assembly/va-senate-democrats-want-special-session-on-state-health-exchange/article_3f6c2cda-3340-11e2-9afe-001a4bcf6878.html
so at least the Va senate democrats are trying, always hopeful if not moot. But I really am so frickin tired of my republican controlled State government... errrrr
Exactly. I'm in VA too, and I couldn't believe Mr. Mc-vaginal ultrasound-Donnell and his party of local-is-better punted, immediately, to the federal government for their exchange. Other states had their exchanges ready for implementation on time; what's his excuse? Republicans truly never had a plan B (pun intended) for Obamacare. The 'party of life' never had a plan to carry Obamacare to term? Really?
oddduck35 ....... i'm a V.A. too ....... you kicked some serious butt on that one ,THANK YOU . In time people will see just what the righty-baggers are all about , it will happen once Obamacare is implemented , We all need Medical Ins. no matter if you are a Republican or Democrat , unless your very wealthy , with the cost of healthcare today you would be bankrupt in a heartbeat , When the rubber meets the pavement all Republicans will use Obamacare . People forget that if you dont use healthcare in that 12 month period you get a refund of
80% of the cost of the annual premium or your boss will if he paid it .
I think the onus is now on the federal government to make this an exemplary program despite the opposition of the Red State governors. Fortunately, we have competent leadership in place to make that happen.
They're really angling for universal healthcare, but they're too chicken to admit it. ;)
Help me to understand this a bit more...during the campaign seasons particularly through the republican primaries, wasn't one of the key and common solutions with replacing ObamaCare to set up state exchanges? My memory is a bit hazey but wasn't this their solution to enabling folks to purchase across state lines and lower premiums by getting into a larger pool?
Well, let's back up a bit:
The understanding is that premium credits are available whether or not the state exchange is run by the state or run by the federal government. There are a couple of conservative law professors who teased one section of the Affordable Care Act to suggest that the premium credits (for those between 100% and 400% of federal poverty level) are ONLY available if the state runs the exchange. But outside of their dog-chasing-tail argument, there is not much support for that reading.
By the way, 400% of poverty level is a big number. About $46,000 agi for single filer, and $92,000 for a family of four. The agi for 2012 will be the one used for the first year of Obamacare (2014).
I can't believe this is going to go on for too long. In fact, Jindal's gop legislature is questioning the constitutionality of the governor's budget.
The medical industry is one of the largest and most vibrant in Texas ... I cannot imagine they are going to allow Perry to refuse billions in federal dollars, that would go directly to them, for too long. Our lege is just about to come in (for the 5 months every 2 years we let them.) I think there is going to be ALOT of noise.
The money doesn't go to healthcare providers. It goes to the states to set up more beaurocracies. And the money the feds will give to the states is not enough to do the job.
Is it 2014 yet?....Not soon enough.
They can take credit for stimulus projects while objecting to the stimulus...they'll do the same with the exchanges...
And yes, Republicans wants government to fail, not just Obamacare. In the mean time, they'll milk what the can out of it. Look at Romney's campaign incompetence--they want to bring that to the federal government. Yet people write about Romney's transition team was in place and how that should be emulated (yet more money to consultants hiring consultants hiring...)