MEDICAID EXPANSION

States with Republican governors that have expanded Medicaid:

Arizona

Arkansas

Iowa

New Mexico

New Jersey

North Dakota

Ohio

Pennsylvania

States with Republican governors considering expanding Medicaid:

Wyoming

Tennessee

Utha

(NOTE THAT THERE’S A PHOTO OF OBAMA VOTING YOU CAN USE WITH THIS)

OBAMA’S DAY

President Barack Obama, who traveled Sunday to his hometown of Chicago to campaign for Illinois Gov. Pat Quinn’s re-election, spent the day there Monday. On his agenda:

Voting

Obama wants Democrats across the country to vote early this year, hoping to boost turnout in a midterm year when Democrats historically tend not to vote. So he put his money where his mouth is, strolling in to a polling place near his house on the first day of early voting in Illinois.

“Barack Obama?” asked the poll worker at the Dr. Martin Luther King Community Service Center.

“That’s me!” the president replied.

Campaigning

Volunteers making phone calls for Quinn got a pep talk from the president — and a less-than-healthy snack.

Making a surprise appearance at one of Quinn’s campaign field offices, Obama brought three cartons of doughnuts, the oil from the pastries seeping through the white boxes.

Would the first lady approve?

“Michelle sent these,” Obama quipped, playing off his wife’s childhood nutrition campaign. “We got broccoli, carrots.”

Getting briefed

Aides said that before heading back to Washington, Obama returned to his house, where he was briefed by phone on the government’s Ebola response by his homeland security adviser, Lisa Monaco.

— Associated Press

.

While Republicans in Congress continue to pledge a repeal of President Barack Obama's health care law, GOP governors in many states have quietly accepted the law's major Medicaid expansion. Even if their party wins control of the Senate in the upcoming elections, they just don't see the law going away.

Nine Republican governors have expanded Medicaid for low-income people in their states, despite their own misgivings and adamant opposition from conservative legislators. Three more governors are negotiating with the Democratic administration in Washington.

Rather than demanding repeal, the governors generally have sought federal concessions to make their decisions more politically acceptable at home. That approach is in sharp contrast to the anti-health law fervor of their party in Congress.

Ohio Gov. John Kasich doesn’t think the Affordable Care Act will be repealed, even if Republicans win a Senate majority and consolidate their hold on the House in next month’s election. “That’s not gonna happen,” Kasich said during a recent re-election campaign swing.

“The opposition to it was really either political or ideological,” he added. “I don’t think that holds water against real flesh and blood, and real improvements in people’s lives.”

In a state pivotal for national politics, Kasich casts Medicaid expansion as a moral choice to help the poor.

And even if Democrats lose their Senate majority, President Barack Obama would still have the power to veto legislation. Republicans would have to muster a two-thirds majority in both chambers of Congress to override it for both a repeal and replacement.

“What we would anticipate is most likely to happen, even with a Republican Senate, is we’d have to work within the confines of where we are,” said Marty Carpenter, spokesman for Republican Gov. Gary Herbert of Utah. Herbert wants federal approval to deliver the Medicaid expansion through private insurance companies — as some other GOP governors have done.

Iowa Gov. Terry Branstad, another Republican seeking re-election, said “major changes” are required to the health care law. But he said he expects his state’s Medicaid expansion to stand.

“I think our system and our approach is working, and I think other states are starting to look at our approach,” Branstad said.

In a recent debate with his Democratic election opponent, Senate Republican leader Mitch McConnell of Kentucky said Obama’s health care law must be pulled up “root and branch.” But he hastened to add that the state could somehow still keep its insurance marketplace, which owes its existence to Obama’s law.

Here are some of the hurdles that congressional Republicans would face, even if they won big on Nov. 4:

• A straightforward repeal bill could be filibustered in the Senate, giving Democrats a chance to turn the tables on Republicans who have used that tactic in recent years.

• Democrats used budget rules to avoid a filibuster and pass the law in 2010. That same budget process might be used by Republicans to unravel the law. But they might not kill all of it — only the parts with a direct impact on the federal budget, leaving an unworkable jumble of insurance rules. And Obama could still veto any change.

• Forcing a government shutdown or a debt default to try to get rid of the health law would probably backfire politically. Republican leaders want to avoid that, though some conservative activists say nothing should be off the table.

• There is no consensus among Republicans over how to replace the law. Some believe a new plan would have to come from the party’s 2016 presidential nominee.

Still, the nation can expect repeal votes if Republicans win the Senate, to fulfill campaign promises. What might happen after an Obama veto is less clear.

Sen. John Barrasso, R-Wyo., a member of the GOP leadership, said Republicans will target unpopular provisions and try to get some Democrats to join them. The list is long, including the law’s 30-hour definition of a fulltime work week, its tax on medical device manufacturers and coverage mandates on individuals and employers.

“Obviously, we are going to try to fully repeal the law,” said Barrasso. “The reality is President Obama is going to be in office, and we know how that is going to turn out if we get a bill to his desk. If we cannot get a full repeal, we will try to bring forth a number of bills that target the worst parts of the law.”

The bottom line: Former Utah Gov. Mike Leavitt, a Republican who served as Health and Human Services secretary for President George W. Bush, said Washington lawmakers and state governors are playing on different levels.

“In the Washington world, things are about control of the news cycle and preparing for the next election,” said Leavitt. “Governors are more interested in finding a way they can be comfortable in their own skins and solve problems.”