First Republican-Controlled States Progress Toward Implementing Obamacare

Despite the fact that President Obama’s reelection ensures his landmark health care reform law is here to stay, intransigent Republican governors across the country have been digging in their heels against Obamacare. GOP officials continue to refuse to implement two of the law’s most important provisions — expanding the Medicaid program and setting up state-run health exchange markets — even as deadlines are fast approaching.

But a few Republican leaders are inching toward reform. On Thursday, the U.S. Department of Health and Human Services approved the first four Republican-controlled states to run their own health insurance exchanges, the online marketplaces that will allow Americans to purchase insurance starting in 2014. HHS has given New Mexico, Nevada, Utah, and Idaho the conditional approval to continue working toward setting up their exchanges this year. The Democratic-controlled California, Hawaii, and Vermont also earned HHS approval to move forward.

This brings the list of states working toward health exchanges up to 18. Two additional states, Arkansas and Delaware, will operate partnership exchanges with the federal government.

On the other hand, stubborn Republican governors in states like Florida and Texas have refused to participate in Obamacare, despite the fact that the health exchanges are projected to extend coverage to 25 million Americans by the end of the decade. When the deadline for submitting a state health exchange plan came and went last month, 30 governors decided not to turn one in. States still have until February 15 to choose to follow in Arkansas’ and Delaware’s footsteps and opt for a partnership with the federal government.

And ultimately, the GOP politicians who aren’t putting in any work toward an exchange in order to continue resisting Obamacare are making a purely symbolic statement. The states that refuse to set up their own exchanges simply cede their control to the federal government, which will step in and set up one for them.