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Obamacare gives Western governors a headache


Western governors are paying a political price for trying to implement President Barack Obama’s health care insurance plan.

Here at home, Republican Gov. Brian Sandoval, who opposed Obamacare, is getting criticism from the conservative right for starting a state health insurance exchange and expanding Medicaid under the law. He is the only GOP governor to do both, at a time when he is running for re-election in 2014.

Idaho Gov. Butch Otter, also a Republican, has it even worse. A state senator, Russ Fulcher, is challenging him in the GOP primary, accusing Otter of wanting to “prop up” Obamacare instead of fight it. Otter’s sin: not expanding health care for the poor but starting a federally supported state exchange.

“There’s such a thing as the rule of law,” Otter said, explaining he had no choice but to implement Obamacare after battling it in court to no avail. “If I could repeal Obamacare I’d do it.”

Even Democratic governors can’t seem to win. Montana Gov. Steve Bullock, a Democrat, has been spurned by the GOP-controlled Legislature, which blocked his attempts to start a state exchange and expand Medicaid. Now the federal government is running Obamacare in Montana, frustrating users as the Obama administration fixes website glitches.

Colorado Gov. John Hickenlooper, another Democrat, got bipartisan approval to launch a state exchange and expand Medicaid. But, as with the federal system, the going hasn’t been smooth in Colorado.

“It hasn’t been without its bumps,” said Hickenlooper, who is up for re-election next year. “It’s a challenge. We’ve got everybody focused on making sure it succeeds.”

POLITICAL HAZARDS

The Western governors, who held their winter meeting last week in Las Vegas, focused on issues such as improving transportation and preventing wildfires, leaving Obamacare headaches at home.

In general, the GOP governors who oppose Obamacare — and even Democrats who support it — said states should have been given more flexibility to develop better health care systems tailored to their individual needs instead of having the federal government shove a one-size-fits-all law down their throats.

“States hate to be told what to do,” said Hickenlooper, chairman of the Western Governors’ Association this year. “But the question is how do we get everybody to get insurance as cheaply as possible? We want our citizens to be healthy.”

Otter said his opponents are always harping on “wanting to get the feds out of the state,” yet he is being criticized for wanting the state to run its own health care insurance system.

“I wanted to run one of the most important things in our state, our health care system,” Otter said. “I couldn’t turn it over to the feds. Everyone who relied on the promises made is now suffering. They were out-and-out lies.”

In selling Obamacare, the president assured Americans they wouldn’t be forced to switch health care plans. That turned out to be false after insurance companies canceled thousands of policies that didn’t comply with the law.

PolitiFact called Obama’s oft- repeated promise — “If you like your health care plan, you can keep your health care plan” — the “lie of the year.”

Otto and New Mexico Gov. Susana Martinez are both partnering with the federal government this year and plan to run their own state exchanges in 2014.

Martinez, like Sandoval, also expanded Medicaid.

Sandoval said that although “historically, I was opposed to the law,” the former federal judge and state attorney general decided to make the best of it after the U.S. Supreme Court upheld the legislation. The high court left it up to the states to decide whether to expand Medicaid, the health care program for the poor.

Sandoval said it would have cost Nevada $30 million not to expand Medicaid eligibility, making his decision easy. The federal government will pick up the full cost of expansion for the first three years and 90 percent after that.

“I made the decision very early we would have a state-based exchange,” Sandoval said. “We would have a state exchange run by Nevadans for Nevadans. Yes, it was a difficult decision, but it was the right decision.”

The Nevada exchange got off to a slow start, with 6,629 signed up by Dec. 8. About 22 percent of the state’s 2.7 million residents aren’t insured, the second -highest rate in the nation behind Texas.

Chuck Muth, a staunch conservative and columnist who distributes a political newsletter, said Sandoval’s decision to fully implement Obamacare “could come back to bite him.”

Sandoval faces no strong GOP primary opponent, although perennial candidate Ed Hamilton is running as a Republican. He also has no major Democratic foe, yet. Libertarian David VanDerBeek also is running and could take some votes away from Sandoval’s column.

Muth argues that those unhappy with Sandoval might vote for the libertarian or a conservative Democrat, especially if Clark County Commissioner Steve Sisolak jumps into the race.

“Sandoval is not yet the shoo-in that many are pretending him to be,” Muth wrote Friday.

OTHER STATES

Utah Republican Gov. Gary Herbert said his state already had a health care exchange for small businesses and didn’t need the federal government to step in.

Herbert failed to get the GOP- controlled Legislature to expand the Utah small business exchange to allow individuals to buy insurance from the state system. As a result, Utah citizens must go through the federal exchange. Utah did not expand Medicaid — Republican lawmakers opposed it — but Herbert said it is still under review as he faces pressure from advocates from the poor.

“Our system wasn’t broken,” Herbert said. “We want to make sure we have the best health care system for all people. Obamacare was partisan, and it divided the country.”

Herbert said each state has different needs. Utah, for example, must offer good prenatal care, because it has the youngest population in the nation with an average age of 29.

“There’s no one-size-fits-all,” Herbert said. “I think we’d be better served if the federal government let each state come up with their own solution, almost like pilot programs. We’d learn from each other. States are the laboratories not only of democracy, but of innovation and creativity.”

“This Obamacare is something else,” he added. “It’s a problem. It’s not working.”

Wyoming Gov. Matt Mead struck the same notes, saying states should have been left alone to improve health care. Now, the federal government is running Obamacare in Wyoming, which has not expanded Medicaid based on Mead’s “no” recommendation to the Legislature.

“If you let us run our state, we could do a better job than the federal government,” Mead said.

Montana Gov. Steve Bullock, a Democrat, agreed. That is why he wanted the state to open its own health insurance exchange, though he failed to get his proposal through the GOP-controlled Legislature. So, the federal government is running Obamacare in Montana, which did not expand Medicaid.

Bullock argued that expanding Medicaid would have added 70,000 poor people to the rolls and created 5,000 jobs. Now, he said, Montana taxpayers are having to pay the price.

“Yeah, it has been frustrating,” Bullock said, adding he may try again to expand Medicaid during the next legislative session.

He has refused pleas from Democrats and advocates for the poor to call a special session on the topic.

Meanwhile, a coalition called the Healthy Montana Initiative is drafting a ballot measure to ask Montana voters in 2014 whether they would like to expand Medicaid.

Arizona Gov. Jan Brewer, a Republican, missed the Western governors’ meeting. But she, too, has paid a political price for pressing the GOP-led Legislature to add 300,000 more poor and disabled Arizonans to Medicaid. The federal government is running the health care exchange program, however.

Brewer opposed Obamacare and, like other GOP governors, she sued to stop it. But once it became law, she argued that expanding Medicaid would be good for Arizona taxpayers and the poor, who had lost benefits. She threatened to veto every bill until the GOP-led Legislature approved the expansion, which it finally did.

Conservative hard-liners are threatening to punish her in 2014. Brewer hasn’t said whether she will run for re-election.

She may first have to challenge a law that limits her to two terms, arguing that her first term, when she was appointed to the job, doesn’t count.

With Brewer’s fate uncertain, several Republicans have announced gubernatorial bids, including Arizona Secretary of State Ken Bennett, Treasurer Doug Ducey and Christine Jones, a lawyer.

The conservative Goldwater Institute also is suing to repeal the Medicaid expansion.

“I knew I had not chosen the easy path,” Brewer said in June, when she signed the Medicaid expansion law. “But I learned a long time ago that what is easy and what is right are rarely the same.”

Contact reporter Laura Myers at lmyers@reviewjournal.com or 702-387-2919. Follow her on Twitter @lmyerslvrj.

 

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