Health overhaul here to stay, governors at conference say

Arkansas Gov. Mike Beebe, left, talks with Iowa Gov. Terry Branstad during the National Governor's Association Winter Meeting's special session on jobs in America, in Washington, Sunday, Feb. 23, 2014. (AP Photo/Cliff Owen)
Arkansas Gov. Mike Beebe, left, talks with Iowa Gov. Terry Branstad during the National Governor's Association Winter Meeting's special session on jobs in America, in Washington, Sunday, Feb. 23, 2014. (AP Photo/Cliff Owen)

WASHINGTON - The politics of health care have seemingly divided the nation, but America’s governors, Republicans and Democrats alike, suggest that President Barack Obama’s health-care overhaul is here to stay.

While governors from Connecticut to Louisiana sparred on Sunday about how best to improve the nation’s economy, governors of both parties shared a far more pragmatic outlook on the 2010 Patient Protection and Affordable Care Act, or “Obamacare,” as millions of their constituents begin to be covered.

“We’re just trying to make the best of a bad situation,” said Republican Gov. Terry Branstad of Iowa, who calls the health-care law “unaffordable and unsustainable,” yet something he has to implement by law. “We’re trying to make it work as best we can for the people of Iowa.”

As governors gathered in Washington during the weekend, Democrats such as Maryland’s Martin O’Malley and Connecticut’s Dannel Malloy made pitches to raise the minimum wage. Republican governors such as Louisiana’s Bobby Jindal and Indiana’s Mike Pence called for more freedom from federal regulations, particularly those related to the health-insurance overhaul.

But governors from both parties report that a full repeal of the law would be complicated at best, if not impossible, as states move forward with implementation and begin covering millions of people - both by expanding Medicaid for lower-income residents and through state or federal exchanges that offer federal subsidies to those who qualify.

“They didn’t come to the states, they didn’t come to the governors” when the act was being considered in 2009 and 2010, said Utah Gov. Gary Herbert, a Republican.

Missouri Gov. Jay Nixon, a Democrat, countered that the act was carefully crafted and will eventually be popular.

“What I tell your grandmother, her Medicare works pretty well,” he said. Though controversial when it was created in 1965, he said, it’s now widely accepted.

Republican opposition to the law is the centerpiece of the GOP’s political strategy ahead of the midterm elections, and not every GOP leader over the weekend embraced the inevitability of the law’s implementation.

“I don’t think that it’s so deeply entrenched that it can’t be repealed,” Jindal said. “But I do think, as we argue for repeal, we have to show folks what you replace it with.”

Despite a troubled rollout, nearly 3.3 million people had signed up through Feb. 1 for health-care coverage under the law. The White House reported that 1 million people signed up nationwide for private insurance under the law in January alone. It remains unclear if the administration will reach its unofficial goal of 7 million people by the end of March, but it still expects several million enrollees by then.

A recent Associated Press analysis of the sign-ups found that six Republican-led states - Florida, Idaho, Maine, Michigan, North Carolina and Wisconsin - were on pace or better than the states had initially projected.

Michigan Gov. Rick Snyder is among several Republican governors who expanded their state’s Medicaid laws under the law.

“The whole dialogue on the Affordable Care Act is about people fighting, causing gridlock and a mess, instead of working on something important like wellness,” Snyder said, adding that he still has “a lot of issues” with the overhaul. “But it is the law, so I’m trying to work in that context.”

Vermont Gov. Peter Shumlin, who leads the Democratic Governors Association, said governors spent about half of their private lunch session on Saturday discussing the health-care law and the tone was much different than in past years.

“Before the election, it felt like a cockfight,” Shumlin said, describing the debate over the law during the 2012 campaign. “Down there we were talking about ways we could cooperate.

“There’s no doubt in my mind that the Republicans have accepted that as millions of people sign up for it and finally get the health care they have been dreaming of for their families, nobody’s going to take that away,” he said.

Yet in Washington, Republican governors described circumstances that would hardly befit a dream.

Democrats and Republicans complained about major problems with the Medicaid eligibility data that they are receiving from federal exchanges. The 36 states in the federal exchange, including Arkansas, have noted often incomplete data with the Medicaid information they are receiving.

Pennsylvania Gov. Tom Corbett, a Republican who is seen as among his party’s most vulnerable incumbents in the fall election, said he’s working to expand his state’s Medicaid program, but the process has been cumbersome and difficult. He said it still remained unclear, from a fiscal standpoint, if the health-care law would be functioning in two years.

“There are a lot more unknowns than there are knowns,” Corbett said.

Oklahoma Gov. Mary Fallin, a Republican, said many governors still have concerns about the program, but outright repeal would be “complicated.”

Republican campaign officials, meanwhile, plan to make the health-care law the overwhelming focus of the coming midterm elections.

From coast to coast, conservatives are attacking Democrats who supported the overhaul, seizing on problems with the program’s website and news that some Americans were forced to change insurers once the law took effect. The conservative group Americans For Prosperity has spent more than $20 million on anti-Obamacare television ads in several key states since last August.

The stakes are high for parties battling over control of the House and Senate, while there are also 36 elections for governor, most of them for governors mansions held by Republicans. The coming elections also offer prospective 2016 presidential candidates an opportunity to boost their political standing.

Leading GOP figures in the Senate like Ted Cruz of Texas and Marco Rubio of Florida have been vocal critics of the health-care law. Cruz mounted a 21-hour Senate speech against Obama’s health law and was tied to the partial government shutdown, while Rubio was an early proponent of defunding the health law, although he distanced himself from the shutdown.

New Hampshire Gov. Maggie Hassan, a first-term Democrat up for re-election in November, said her state would soon expand its Medicaid program to cover 50,000 uninsured residents.

“Overall, I’m very disappointed with the early implementation and rollout,” she said. “But I think we are making progress.”

Meanwhile, the governors planned to meet this morning with Obama and members of his Cabinet, on the last day of a four-day conference. Problem-solving, rather than politics, is expected to dominate the agenda.

Jindal set the tone for the meeting during an interview with Washington Post reporters Sunday afternoon. “The president’s going to try to lecture us on the same themes he’s been campaigning on across the country, and our response is that his policies are actually making that division worse.”

Jindal, noting that Obama has said he is determined to use his executive powers more freely, said he would urge the president to use his authority to speed energy production on federal lands, approve the Keystone XL pipeline and support additional delays in the healthcare law’s mandates - all key Republican proposals that are not likely to find favor with the president.

White House officials sent out an email Sunday afternoon outlining actions Obama plans to take this week on manufacturing and infrastructure. The message said Obama planned to use the meeting with the governors to “enlist them to make real progress on issues that matter to Americans.” Information for this article was contributed by Ken Thomas and Steve Peoples of The Associated Press; by David Lightman of the McClatchy Washington Bureau; and by Dan Balz, Karen Tumulty, Philip Rucker and Robert Costa of The Washington Post.

Front Section, Pages 1 on 02/24/2014

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