Tuesday, June 2, 2015

The Perils Of Obstruction

When the Supreme Court ruled that Obamacare could not require states to set up exchanges, a lot of Republican governors, including Rick Scott of Florida, chortled with glee.  They were sure that this was the death knell of the evil law.

It’s not exactly working out that way.

Tonight the Wall Street Journal has a fascinating look something we may soon hear a lot more about in a very rushed and chaotic fashion. Last month, an outfit called the Milbank Memorial Fund (as best I can tell a relatively non-ideological foundation focused on health care policy) held a secret one day meeting in Chicago for officials from states who may suddenly find their citizens cut off from Obamacare health care insurance subsidies because of the new GOP challenge to the law.

The verdict. Basically that they’re screwed.

There’s simply no way for states to set up exchanges in time for this year – just at the purest technical level, setting aside whatever politics are involved. And that’s setting aside a lot because Republican controlled state legislatures in particular are staunchly against budging in favor of facilitating the functioning of the law. Governors – even GOP governors – tend to be a bit more pragmatic since they face state-wide electorates and are most likely to bear the brunt of any backlash.

Republican state legislatures seem likely to sit back and let the agony happen. At least for a good long time.

The Florida legislature has gone into special session in order to work out their differences over the state budget that they couldn’t resolve during the regular session, and those differences are all centered around health insurance.  Everything in the state budget, from education funding to Everglades restoration, hinges on this special session budget negotiations.  Despite attempts to make nice, so far there is no sign that the Republicans will accept one red cent of federal money to offset the costs to hospitals of paying for people with no insurance.

If the Supreme Court goes nuts and rules against exchanges, a lot of states are going to look back at the good old days when they were merely learning a physics lesson.

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