Governors in key states buck GOP on health care

The governors’ reluctant acceptance is based on what they call financial prudence and what appears to be political necessity.

“My approach is to not spend a lot of time complaining,” Iowa Gov. Terry Branstad said recently. “We’re going to do our level best to make it work as best we can.”

It’s the same view embraced by fellow Republicans John Kasich of Ohio, Susana Martinez of New Mexico, Brian Sandoval of Nevada, Rick Snyder of Michigan and Rick Scott of Florida.

It’s also in stark contrast to the approach taken by Republicans in Washington, where the GOP-led House repeatedly has voted to repeal the law. Congressional Republicans may keep at it this fall to force a budget showdown even though the U.S. Supreme Court has upheld the law.

After initial gripes, these Republican governors are now trying to expand health insurance programs for lower- and moderate-income residents in exchange for billions in federal subsidies. Some governors are building and running online insurance exchanges for people to shop for insurance, instead of leaving the task to the federal government.

While all face re-election next fall in states that Democrat Obama won in both his White House races, these Republican governors say the 2014 elections and political calculations are not driving the health care decisions.

But a year after Democrats succeeded in casting Republicans as the party of the prosperous, the governors could blunt criticism they are ambivalent to the poor by embracing billions in federal dollars to cover millions of residents without insurance.

Lori Lodes of the Center for American Progress, a liberal-leaning think tank that supports the law, put it this way: “They can’t risk pursuing a partisan agenda that would turn down taxpayer dollars and deny their constituents health care.”

Some Republican governors are willing to take the chance that Democrats will cast them that way for opposing the measure. Wisconsin’s Scott Walker, who is considering a presidential run in 2016, has rejected all aspects of the law. These Republican governors find comfort in surveys that show more people in the United States disapprove of the law than approve of it.

But Republican governors who have embraced the law are making a different calculation, believing they will benefit politically as more people get insurance.

“People are seeing that they are going to have access to health care that they don’t have now and that they’ve never had, and with the support of the subsidies, the cost is going to be significantly lower,” said state Rep. Greg Wren, an Alabama Republican who is co-chairman of the National Conference of State Legislature’s health care committee.

Ohio’s Kasich, with a potentially difficult re-election road, promotes expanding Medicaid as a moral issue.

Kasich advisers say agreeing to include more low- and moderate-income people in the program could soothe relations with female voters or independents angry about the budget he signed in July that included new restrictions on abortion.

“Among suburban women, it could soften his image,” said Bob Klaffky, a Kasich adviser.

Three other Republican governors have agreed to the Medicaid expansion: Jan Brewer of Arizona, Chris Christie of New Jersey and Jack Dalrymple of North Dakota. Arizona, where Brewer isn’t seeking re-election, and North Dakota are Republican-leaning states; New Jersey, where Christie is running this fall, is considered Democrat-leaning.

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