Louisiana’s Republican Governor, Bobby Jindal, has announced his state will not create a health insurance exchange mandated by the Patient Protection and Accountable Care Act.
Confirming an earlier report in Health Care News, Gov. Jindal’s press office released a statement on the anniversary of Obamacare’s passage indicating the governor would be directing the state government not to implement an exchange. PPACA requires every state to submit a plan for their exchange to the Department of Health and Human Services by January 1, 2013.
“Obamacare is a terrible policy that needs to be repealed and replaced. It creates enormous new costs and future unfunded liabilities for states financing their Medicaid programs,” Jindal press secretary Kyle Plotkin said in a statement.
Not Alone in Opposition
Other Republican governors, such as Nathan Deal in Georgia, Susana Martinez in New Mexico, Rick Perry in Texas, and C.L. “Butch” Otter in Idaho, have announced opposition, vetoed bills, or issued executive orders as ways to prevent implementation of a health exchange.
Florida’s governor, Rick Scott, also a Republican, has stood adamantly against the exchanges. Scott has spoken out against Obamacare from the start and first became a candidate after his strong opposition to the legislation.
John Graham, director of health care studies at the California-based Pacific Research Institute, points out both Jindal and Scott have backgrounds in health care. Jindal was Louisiana’s state secretary of health before becoming governor, and Scott helped run one of the world’s largest health care providers.
“I believe that they learned—correctly—that anti-Obamacare state politicians should not be collaborating in Obamacare in any way. There is no way for a state to put ‘market-friendly’ elements in a state-based exchange,” Graham said.
Some Republicans on Board
Not all governors are standing with Jindal and Scott, however. Mississippi’s governor, former Republican Governors Association chairman Haley Barbour, has publicly announced support for an exchange, and Virginia Gov. Bob McDonnell has supported an exchange law, albeit with restrictions against payments for abortions.
That is shortsighted, Graham says. “The federal Obamacare legislation states very clearly that state laws which establish exchanges cannot impose rules that differ from the U.S. Secretary of Health and Human Services’ regulations, which will change through time,” Graham said. “If the Supreme Court finds Obamacare constitutional, it means that the Supremacy Clause will give the Secretary the power to nullify state law.”
Graham said governors and legislators who oppose PPACA have several other options to defy the mandate, as well.
“States have more power to resist Obamacare exchanges than they believe, because the federal law also states that the Secretary can only allow health plans to participate in an exchange if they are licensed and in good standing with the state,” Graham notes. “This gives state legislators and insurance commissioners a lot of leverage over the health plans that are right now lobbying to establish exchanges.”
Sarah McIntosh, Esq. ([email protected]) is a constitutional scholar writing from Lawrence, Kansas.