Republican governors vowed not to implement the state based insurance exchanges until after the election. There is also talk of resisting the Medicaid expansion called for in the bill.
The Republican governors' message was clear on a morning Republican National Committee conference call, when Jindal and McDonnell stressed their continued defiance of the Affordable Care Act and said they will resist implementing the state-based health insurance exchanges for which the law calls.
"Here in Louisiana, look, we refused to set up the exchange. We're not going to start implementing Obamacare," Jindal said. "We have not applied for the grants, we have not accepted many of these dollars, we are not implementing the exchanges, we don't think it makes any sense to implement Obamacare in Louisiana."
The response from GOP governors was similar elsewhere. Christie, on his monthly radio call-in show, said he would again veto legislation creating a New Jersey health insurance exchange if his state Legislature passes it.
"I am in no hurry to do that, and especially because we have an election four months away," Christie said when asked if he would allow for the creation of a state exchange. "If there are any hard deadlines that New Jersey has to comply with or be in violation of the law, we'll comply with it. But I don't think you are going to see any of those things between now and November."
McDonnell said that in Virginia -- where lawmakers have already adopted language authorizing but not yet creating a health insurance exchange -- twice didn't answer direct questions about whether he would seek to have his state implement an exchange. Instead, he told reporters on the RNC call, that states like his will have decisions to make.
"Each state now needs to decide whether or not it makes sense to enact its Medicaid expansion, which of course comes with a cost of a real hit to Medicare as well as the very likely flight of people from small-business policies now into a government-run Medicaid program," said McDonnell, who is prevented by state law from seeking reelection.
The governor's actions would be mostly symbolic. If a state fails to set up an insurance exchange, the bill authorizes HHS to do it for them. As far as Medicaid expansion, the governors could refuse but the people who would be eligible for the program would have to get hardship waivers or have their insurance subsidized by the rest of us.
Still, it makes sense not to spend any money on setting up a program that might be repealed in a few months. In that respect, the Republican governors are the best possible spokespeople to explain Obamacare to the voters.