Republican governors in Texas (Rick Perry), Louisiana (Bobby Jindal), Wisconsin (Scott Walker), Ohio (John Kasich), Maine (Paul LePage), South Carolina (Nikki Haley) and 13 other states have said they would not implement state healthcare exchanges under Obamacare.
But their refusal to do so could cede control of their exchanges to the federal government, which would give the federal government even more control over healthcare.
Some conservatives believe governors should refuse to implement the exchanges and sue the federal government when it tries to impose exchanges on the states, which could cripple Obamacare in the courts. Groups such as Americans for Tax Reform have encouraged Republican governors to reject the healthcare exchanges.
Other conservatives like Heather Gerken, a constitutional law professor at Yale University, feel governors would be giving up state powers -- and their ability to shape the exchanges in a conservative manner -- to the federal government by rejecting the exchanges.
And Paul Clement, the lead lawyer who argued against Obamacare in the Supreme Court, said if states cede control to the federal government, they could be blamed by voters for everything that goes wrong with the health exchanges.
Clement said since a citizen’s first point of contact is with the “state Department of Health and Human Services,” he will most likely blame the state for an “outrageously stupid rule” even though the rule was a federal one.
This debate is playing out in public in Mississippi.
According to Politico, Mississippi's insurance commissioner will set up a health exchange even though the Republican Gov., Phil Bryant, said that he regretted the commissioner’s decision and letter of intent because health exchanges are “one more step toward the largest entitlement program expansion in American history.”
Republican governors in Florida (Rick Scott), New Jersey (Chris Christie), and Arizona (Jan Brewer) are undecided. Republican governors in states like Iowa (Terry Branstad) and New Mexico (Susana Martinez) announced announced their states would build health exchanges.
Health and Human Services Secretary Kathleen Sebelius last week extended the Friday deadline for when states need to decide whether to implement exchanges by a month.