This past Friday was the final deadline for governors to decide whether they will take some ownership over setting up a state-level health insurance exchange, as stipulated by the Affordable Care Act. But even though the Republican Party typically resists handing over any power to the federal government, the vast majority of GOP governors have decided to cede control over their own insurance marketplaces to federal officials — an uncharacteristic move that’s out of step with GOP ideals.
As stubborn Obamacare opponents continue to resist implementing the health care reform law, most governors have refused to do any work to set up an insurance marketplace. But those GOP-led states’ refusal won’t actually bring health reform to a grinding halt; instead, it has invited the federal government to step in and do the work for them. Altogether, the federal government will run health exchanges in 26 states, and partner with state officials in an additional seven states to help them set up their marketplaces:
Even though you wouldn’t know it from looking at the partisan breakdown in the chart above, state-run health exchanges are actually a conservative idea. Democratic proponents of reform initially advocated for a nationally-run insurance marketplace, but the final version of the health reform law gave more control to states in order to compromise with conservatives. Republican governors are now largely refusing to take advantage of the power that the law affords to them.
Ironically, as Wonkblog’s Sarah Kliff points out, GOP leaders’ refusal to set up their own exchanges means they’re defaulting to a more liberal version of health care reform. Some members of the Republican Party have already recognized this — but their attempts to convince their colleagues to implement Obamacare on a state level haven’t been met with much success, since the facts don’t matter to the partisan lawmakers who will stop at nothing to oppose the health reform law.