Politico...
Republican governors
move ahead on health exchanges
By Sarah Kliff
5/29/11
A small but growing number of prominent, Republican governors —
including Mitch Daniels and Haley Barbour — are taking the lead to
shape a key component of the health care overhaul their party fought so
hard to kill.
It’s a delicate balancing act for Republicans who, on the one hand,
oppose federal health reform, even challenging its constitutionality in
federal court, and, on the other hand, are pragmatically trying to
control as much of the implementation process as they can.
In Indiana, Gov. Mitch Daniels issued an executive order that allowed
the state to become one of just three to receive a multimillion dollar
grant to establish a health exchange, the online insurance marketplaces
that all states must eventually have if the reform law stands up in
court.
Wisconsin, under the leadership of Gov. Scott Walker, is one of six
states to win an Early Innovator grant. While the grant was received
under Walker’s predecessor, Gov. Jim Doyle, Walker has continued to use
the resource, setting up the Office of Free Market Health Care that has
prominently advertised its innovator status.
And in a weird twist of politics in Mississippi, state agencies of Gov.
Haley Barbour have relied on little-used statutory authorities to set
up an exchange, reviving a Democratic-sponsored effort to do so through
the Mississippi State Legislature.
Daniels, Walker and Barbour are a stark contrast to Republican
governors who are more stridently opposed to all aspects of health
reform. Govs. Rick Scott of Florida, Bobby Jindal of Louisiana, and
Susana Martinez of New Mexico have come out in fierce opposition of any
kind of implementation.
Scott and Jindal have also shunned federal money to plan their
exchanges.
“The Rick Scotts of the world are probably going to be in the
minority,” says one Republican health policy source, referring to the
Florida governor’s halting health reform implementation. “The ones that
block it fundamentally have a disagreement or it fits into a broader
political calculus.”
Many strategists in D.C. contend that setting up the exchanges
undermines Republicans’ constitutional challenges to the health reform
law.
But having a handful of prominent Republican governors move forward on
the issue — two of whom weighed presidential runs — suggests that the
exchanges could emerge as one of the more palatable provisions of the
contentious law.
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