Conservative Republican legislators in major states are trying to block efforts by more pragmatic governors of their own party to accept health insurance for more low-income residents under President Barack Obama’s health care law.
Unlike their congressional counterparts, who’ve misfired in repeated attempts to torpedo the law, state Republicans may well sink the expansion of Medicaid in populous states such as Florida and Michigan.
That would mean leaving billions of dollars in federal matching funds on the table and hundreds of thousands of the poor uninsured. Expansion opponents say it’s an issue that goes to their core beliefs.
“It’s an ideological principle piece to us on the conservative side,” said state Rep. David Gowan, majority leader in the Arizona House of Representatives. “We don’t believe in the expansion of Medicaid itself — it’s within the process of mandating health care. We don’t believe it’s the government’s duty to do that. It should be open for people to go get their health care.”
Nine Republican governors supported or accepted the Medicaid expansion, a major component of the health care law taking effect Jan. 1. It’s designed to provide coverage to about 20 million uninsured people if all states accept. Washington would pick up the full cost for the first three years and 90 percent over the long haul.
Those helped would mainly be low-income adults with no children at home, people working jobs that pay little and don’t come with health insurance. For uninsured adults below the poverty line, expanded Medicaid is the only way to get coverage under the new law. But middle-class people will be eligible for subsidized private insurance.
Overall, 23 states plus the District of Columbia, are planning to expand their Medicaid programs. About a dozen are undecided.
The nine GOP governors supporting expansion are Jan Brewer in Arizona, Rick Scott in Florida, Terry Branstad in Iowa, Rick Snyder in Michigan, Brian Sandoval in Nevada, Chris Christie in New Jersey, Susana Martinez in New Mexico, Jack Dalrymple in North Dakota and John Kasich in Ohio.