Policy Documents

Governors Request Expedited Review, Flexibility from Administration

Benjamin Domenech –

As governors across the country continue to determine how to respond to the demands of President Obama's health care law in the wake of two key court decisions which found it unconstitutional, twenty-eight Republican governors have written to the White House seeking support for an expedited Supreme Court review of the law.

The governors request that President Obama direct the U.S. Department of Justice to support an expedited appellate process for the pending healthcare lawsuits to reach the United States Supreme Court as soon as possible.

"Given the daunting and costly financial and regulatory burdens that our states and the private sector will face in implementing PPACA over the coming years, particularly during this unprecedented budgetary time, public interest requires expediting a final resolution of the litigation to give certainty as soon as possible," the governors write. "We should not endure years of litigation in the circuit courts, when the Supreme Court can promptly provide finality."

Support for expedited review at the Supreme Court level has gathered support from several elected officials in Washington, including Democrat Sen. Bill Nelson of Florida.

Second Letter in a Week

This latest request from the states follows on a letter Monday from twenty one Republican governors, who wrote to HHS Sec. Kathleen Sebelius demanding more flexibility from the requirements to form state level insurance exchanges.

Citing the uncertainty caused by court decisions against the law in Florida and Virginia, the governors laid out six proposed changes to the law, calling for the elimination of mandates on benefit coverage, a harder line on income verification to determine eligibility for subsidies, and the waiving of provisions that "discriminate against consumer-driven health plans, such as health savings accounts."

“Many of us believe the Patient Protection and Affordable Care Act should be repealed by Congress if the courts do not strike it down first,” the governors wrote, “But, with no assurance of either outcome, we face the decision of whether to participate in the bill by operating state exchanges.”

The letter was signed by Gov. Haley Barbour of Mississippi, who has endorsed a state-level exchange and told Health Care News he would not sunset the exchange if Obamacare was repealed. The Mississippi House has since passed an insurance exchange bill, putting the state well in advance of the January 1, 2013 deadline for review by the federal government.

The letter was also signed by Gov. Bobby Jindal of Louisiana, who does not plan to set up an exchange. But it was not signed by eight Republican governors, including Gov. Rick Scott of Florida, who has declined to set up an exchange and returned the exchange-focused $1 million grant to the federal government. Scott did, however, sign the letter calling for expedited review.

States Continue to Demand Flexibility

One of the chief areas where states are demanding flexibility concerns Medicaid, where increased eligibility threatens to bankrupt several states. Indiana Gov. Mitch Daniels recently proposed a solution to the challenges many states are facing in regards to this particular problem. He wants the Administration to allow states to create multistate insurance pools funded by federal block grants -- an idea Texas Gov. Rick Perry, the new head of the Republican Governors Association, endorsed in an interview with Health Care News.

"The current Medicaid expansion under Obamacare would cost the state of Texas more than $30 Billion over the next ten years if it were to go into effect," Perry said. "We need a system that allows for people to choose whatever fits their needs, not just a one size fits all solution from Washington."

According to a spokesperson for the Texas Dept. of State Health Services, the state is examining the costs necessary of this plan currently, following on earlier research into opting out of Medicaid entirely.

"No one has more at stake than we do," Perry said. "We need more flexibility at the state level."

Benjamin Domenech (bdomenech@heartland.org) is managing editor of Health Care News.