Most of us view Obamacare as a national fight, but over the next few months we will have the opportunity to disrupt this travesty on a local level. Governors and state legislators can refuse to expand the Medicaid rolls as prescribed under Obamacare, pursuant to the Supreme Court's decision. Moreover, there is no mechanism in place to prevent them from blocking the establishment of the healthcare exchanges before the law is set to take effect 2014.
Remember that although we lack control over the federal government, we have full control over 23 state governments (governor +both chambers of the legislature). In total, there are 29 GOP governors and 39 states where we have control of at least one branch of government. We must push those governors and state legislators to block implementation of any aspect of Obamacare. The 29 governors could easily bock it simply by doing nothing. Alaska Governor Sean Parnell is the latest to refuse to implement Obamacare exchanges. Even in states with Democrat governors, state legislators can pass laws banning implementation or cut off funds to support the exchanges.
Kentucky Republicans provided a small but instructive example for disrupting Obamacare. Kentucky is one of those red states that stubbornly holds onto Democrat governors. The current occupant of the statehouse, Steve Beshear, was all too eager to implement Obamacare. On Tuesday, he signed an executive order creating a healthcare exchange for residents to purchase insurance under the confines of the individual mandate. Now Republicans in the General Assembly want to block funding for it, according to the Lexington Herald Leader:
Gov. Steve Beshear signed an executive order Tuesday to create an online marketplace offering health insurance plans for Kentuckians, as called for in the federal Affordable Health Care Act.
Shortly afterward, the Kentucky General Assembly’s Capital Projects and Bond Oversight Committee rejected, on a 3-4 partisan vote, a proposal by the Cabinet for Health and Family Services to spend $294,540 for rental space to accommodate 210 employees associated with the health insurance exchange.
Although Governor Beshear plans to circumvent the committee vote, there are many other ways that state legislatures can hamstring the Obamacare exchanges. While the federal government has promised to pay for the exchanges in 2014, states will be left holding the bag for the subsequent years. This will require states to shift spending priorities or raise taxes. We need to nationalize and localize the fight over Obamacare and demand that state legislators – especially those in Republican-controlled chambers – deny all funding for Obamacare programs.
Despite the growth of the federal government, many aspects of politics are still local. Republicans must be willing to exercise that power and stand up to the Obama administration when most state legislatures reconvene next year. We’ll be keeping track of which governors and state legislatures stand on the side of freedom.