Stubborn Republican Governors Remain A Roadblock To Health Care Reform

President Obama’s re-election this week solidified the fact that his landmark health care reform law will be sticking around. Even conservative health policy analysts are beginning to admit defeat, acknowledging that their long fight to repeal Obamacare is certainly a losing battle. But when it comes to effectively implementing Obamacare across states to ensure that 30 million previously uninsured Americans have access to health care by 2014, intransigent Republican governors could still stall the process by continuing to resist key pieces of the health care law.

Over the past year, GOP lawmakers have continually resisted two of Obamacare’s important state-level provisions: setting up state-run health insurance exchanges and expanding the eligibility threshold for the Medicaid program. At least eight governors insisted on putting off their decisions about implementing Obamacare after the presidential election, just in case a Romney win would have eliminated the need for them to cooperate with the health law. But as Wonkblog’s Sarah Kliff notes, that excuse has run out and those lawmakers now need to take a different approach:

In the wake of President Obama’s reelection, and with the Affordable Care Act’s future secured, Republican-led states are scrambling to figure out what comes next for the law they squarely oppose.

“The folks who need to restrategize at this point are going to be the Republican governors, for the most part,” says Cheryl Smith, a director at Leavitt Partners, the health consulting firm founded by former Health and Human Services Secretary Michael Leavitt.

“They can’t just say no anymore. They have to accept that the Supreme Court ruling was what it was, and that the status quo is not sustainable.”

Nonetheless, some Republican governors are already digging in their heels. Gov. Rick Scott (R-FL) — one of Obamacare’s most vocal critics, despite the fact that his state has some of the highest rates of uninsurance in the nation — has already said that Obama’s re-election doesn’t change anything for him. Scott will not change his decision to reject the Medicaid expansion, denying health coverage to 1 million low-income Floridians who could have otherwise accessed the program, and he plans to continue avoiding setting up a federal exchange.

On Tuesday, voters in Florida actually rejected a meaningless anti-Obamacare ballot initiative that would have attempted to prohibit individuals and employers from participating in a health exchange under the law. And when it comes to Medicaid, nearly two-thirds of white Southerners in states like Florida actually support expanding the program. But for stubborn GOP lawmakers like Scott, resisting Obamacare is a matter of partisan principle rather than following through with the policies that voters support. In the upcoming weeks, Scott’s fellow Republican governors will need to decide where they fall.