GOP should let Obama deal with Obamacare mess
In June, the Supreme Court upheld the individual mandate in President Obama's national health care law. The mandate makes possible an expansion of Medicaid and the establishment of subsidized health insurance exchanges. These two provisions will be responsible for $1.7 trillion in spending over the next decade, according to the Congressional Budget Office. Together, they are expected to provide insurance to 30 million Americans and create the infrastructure that liberals hope to use to push the nation, over time, into a fully government-run health care system.
With Obama re-elected, repeal ceases to be an option for at least the next four years. So 30 Republican governors will have to make a decision about whether they want to help the federal government implement Obamacare, or leave the onus on the Obama administration.
One of the silver linings of the Supreme Court decision is that it let states opt out of the Medicaid expansion. Medicaid is one of the programs that is crushing state budgets. If implemented as intended, Obamacare would add 18 million beneficiaries to the program's rolls. Though the federal government lures states with a honey pot in the short term -- covering all of the expansion through 2016 -- by 2020 the states will be asked to kick in 10 percent of the cost, amounting to billions of dollars of spending imposed on states nationwide each year. It would be to the long-term benefit of governors to opt out of the expansion.
Separately, the health care law was designed to coerce governors into embracing exchanges on which individuals will be provided with federal subsidies to purchase insurance. If a state doesn't establish its own exchange, the law specifies that the federal government will step in and set one up for them. Given that Republicans typically favor more state and local control, there's a clear temptation to create the exchanges themselves. But they should resist that temptation. ...