Their best shot at eliminating the Affordable Care Act gone, Republican governors say the next step is to ensure Mitt Romney and a Republican Senate have another chance to axe it in Congress. In the meantime, though, the ACA is the constitutionally sound law of the land and each state has to figure out how to actually implement it.
Louisiana Gov. Bobby Jindal (R), in a press call with fellow Gov. Bob McDonnell (R) of Virginia, offered up a pretty simple approach: Just pretend the law doesn’t exist.
“We’re not going to start implementing Obamacare,” Jindal said flatly. Under his watch, Louisiana will not set up any of the required state heath care exchanges where, starting in 2014, Americans will be able to buy subsidized private health insurance.
McDonnell was more cautious. “There’s still some uncertainty at this point as to what the right course is,” he said. McDonnell also said he would be “evaluating the case.”
Assuming the law survives to that point, however, denying its legitimacy won’t actually work. The ACA empowers the federal government to step in and create its own exchange, preventing any single governor’s tantrum from depriving constituents coverage.
The Supreme Court’s ruling, however, does give an opening for states to reject funding for a major expansion of Medicaid. Previously, states were all but required to take the cash and its accompanying guarantees to expand coverage to residents at higher incomes, or face losing out on Medicaid funding entirely. But the court ruled that such penalties were unconstitutional, giving states the option to refuse the new expansion of the program.
Democrats and health care advocates are skeptical that conservative governors will be willing to turn the money down, no matter how much they publicly loathe the law that generated the cash. While both Jindal and McDonnell strongly criticized the Medicaid expansion on Friday, neither explicitly pledged not to take the money.
“This law will be repealed well before the effective date,” Jindal said. “Many of these provisions don’t take effect until Jan. 1, 2014.”
While the White House is confident that voters won’t want to re-fight the health care wars given the current focus on jobs and the economy, Jindal and McDonnell insisted that the issues were inseparable and that Romney would make undoing health care his top priority upon taking office.
“If you’re focused on jobs you need to get rid of the biggest federal power grab in American history,” McDonnell said.
Jindal also offered up an accidental reminder of the awkwardness of making Romney, the only person in America other than Obama to sign a health care mandate into law, the tip of their spear. The Louisiana governor accidentally referred to “Obamneycare,” the mocking label critics of Romney used during the Republican primaries to describe the law and Romney’s role in pioneering it, before catching himself and calling it “Obamacare.”
Benjy Sarlin is a reporter for Talking Points Memo and co-writes the campaign blog, TPM2012. He previously reported for The Daily Beast/Newsweek as their Washington Correspondent and covered local politics for the New York Sun.