Republican governors decide against setting up ObamaCare insurance markets

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Several Republican governors, in what could be their last symbolic stand against ObamaCare, announced Friday that they will not set up a state-based marketplace for selling health insurance.

A total of 20 states have now decided not to implement their own exchanges -- which could also mean increased costs for the federal government.

The governors of Wisconsin and Ohio joined Texas Gov. Rick Perry and others in confirming that they will not establish so-called "health insurance exchanges," which are set to launch in January 2014. Under the federal health care overhaul, these exchanges will act as virtual markets where people and small businesses can shop for private coverage in a regulated environment. Many will also be eligible for government subsidies.

The governors' move does not stop those exchanges from being implemented. Rather, it kicks the project back to the federal government to run with regard to those states. While a number of states, largely those run by Democrats, will establish their own exchanges, Republicans who declined argued that it wasn't worth the cost and resources to set up a marketplace that would be under the thumb of the federal government anyway.

"As long as the federal government has the ability to force unknown mandates and costs upon our citizens, while retaining the sole power in approving what an exchange looks like, the notion of a state exchange is merely an illusion," Perry wrote in a letter to Health and Human Services Secretary Kathleen Sebelius. "It would not be fiscally responsible to put hard-working Texans on the financial hook for an unknown amount of money to operate a system under rules that have not even been written."

Wisconsin Gov. Scott Walker said the same, writing in a letter to Sebelius Friday that "no matter which option is chosen, Wisconsin taxpayers will not have meaningful control over the health care policies and services sold to Wisconsin residents." With that in mind, he wrote, the state has decided not to build its own system. Ohio Gov. John Kasich echoed that point of view.

Republican governors have been largely opposed to the health care law anyway. But for months, they were effectively waiting to see if the Supreme Court would overturn it or whether Obama would lose re-election and potentially leave an opening to repeal it. Neither of those things happened.

Walker was among those who stopped implementation last year on the hopes the law would be overturned either by the U.S. Supreme Court or Republicans following the November election.

Thursday evening, the Obama administration responded to a request for more time from Republican governors on the exchange question by granting states a month's extension, until Dec. 14.

A few states have signaled they want to partner with the federal government, as opposed to running it themselves or handing the reins to Washington. Those states would handle consumer issues and oversight of health plans in the exchanges, while the feds do the heavy lifting by enrolling individuals for coverage and determining who's eligible for government assistance. Among these states are Arkansas and North Carolina.

The number of partnership states could grow significantly, since the Obama administration has given states until next February to decide on that option.

Obama's election victory virtually guaranteed the survival of his health care law, which is eventually expected to provide coverage to more than 30 million people through the exchanges and expanded Medicaid programs. It was the final hurdle, after the Supreme Court upheld a legal challenge from 26 states. In the aftermath of the election, some Republican state leaders say it's time to accept the law.

"I don't like it; I would not vote for it; I think it needs to be repealed. But it is the law," said Mississippi Insurance Commissioner Mike Chaney, after announcing that his state wants to set up its own exchange. "If you default to the federal government, you forever give the keys to the state's health insurance market to the federal government."

Traditionally, states have regulated the private health insurance market.

But other Republican-led states say they don't have enough information to make a decision at this point and are clamoring for the Obama administration to release major regulations that have been bottled up for months.

"States are struggling with many unanswered questions and are not able to make comprehensive far-reaching decisions prudently," Govs. Bob McDonnell of Virginia and Bobby Jindal of Louisiana wrote Obama earlier this week. They asked for a meeting with the president, as well as a postponement of the original Nov. 16 deadline.

Some of their main concerns are hidden costs of operating the exchanges and the sheer bureaucratic complexity of the new system. The Obama administration has steadfastly maintained it will not postpone the Jan. 1, 2014, launch date for the law's coverage expansion. Open enrollment for exchange plans will begin even sooner, Oct. 1, 2013.

The Associated Press contributed to this report.

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Palin urges GOP governors to keep Democrats honest

By BRENDAN FARRINGTON 

MIAMI (AP) — Sarah Palin called on fellow Republican governors to keep the new president and his strengthened Democratic majority in check on issues from taxes to health care as she signaled she'll take a leadership role in a party searching for a new standard-bearer.

Addressing the Republican Governors Association meeting Thursday, this year's GOP vice presidential nominee — and an oft-mentioned candidate for 2012 — revisited some aspects of the bitter campaign and talked about the role of the governors in the coming year. After losing the White House and several seats in the Senate and House, the party is engaging in some soul-searching about its direction.

"We are the minority party," Palin said at a session on "Looking Towards the Future: The GOP in Transition." "Let us resolve not to be the negative party."

Still, she took a swipe or two at President-elect Barack Obama. She said with governors, "the buck stops on our desk. ... We are not the many voting yea or nay or present." While an Illinois state lawmaker, Obama often voted "present," a practice the GOP criticized during the campaign.

Palin noted that Congress is led by the likes of House Speaker Nancy Pelosi, Senate Majority Leader Harry Reid and Rep. Barney Frank, and said it was incumbent upon GOP governors to ensure that the federal government doesn't take over the health care system. She said if Obama and the new Congress "err on the side of excess taxes, we have to show them the way."

"Let's reach out to Barack Obama," Palin said. "Show him how lower taxes provide opportunity for the private sector to grow."

Palin also displayed a sense of humor, telling the governors at the beginning of her remarks that she wanted to catch them up on the developments in her life since they last met.

"I had a baby, I did some traveling, I very briefly expanded my wardrobe, I made a few speeches, I met a few VIPs including those who really impact society like Tina Fey," she said to loud laughter.

Facing the prospect of being out of power at both ends of Pennsylvania Avenue for the first time since the 1992 election, Republicans are looking to their governors to fill the leadership vacuum. Speculation has centered on the telegenic Palin despite her tumultuous two months on the national political scene. She likely would have competition for a possible 2012 bid from Mississippi Gov. Haley Barbour, Florida Gov. Charlie Crist, Minnesota Gov. Tim Pawlenty and Louisiana Gov. Bobby Jindal — all in attendance at the three-day meeting.

Republican governors acknowledged that Palin would be a party leader.

"She is somebody who is going to be one of the voices in helping to lead the party in the months and years ahead," Pawlenty said. "We're going to need a whole team, but she's clearly going to be one of the voices that people are going to look to for some perspective on various issues."

In a series of national television interviews, Palin did not rule out seeking the presidency, saying, "It's crazy to close a door before you know what's even open in front of you."

Before briefly taking questions from reporters Thursday morning, Palin said, "I, like all of our governors, we're focused on the future. The future for us is not the 2012 presidential race. It's next year and our next budget, and the next reforms in our states and in 2010 we're going to have 36 governors' positions open across the U.S. That's what we're focused on."

Governors showed their support for Palin, who critics have said was ill-prepared to be vice president and may have cost Republican nominee John McCain support from independent and moderate voters. Undermining Palin's credibility and hockey mom image was her $150,000 wardrobe bought with GOP dollars and her halting interview performances.

Six in 10 Americans said Palin is not qualified to become president, according to exit polls of voters in last week's election. That included nine in 10 Democrats, nearly two-thirds of independents and a quarter of Republicans. The exit polls were conducted for The Associated Press and the television networks.

Twelve of Palin's peers joined her for the news conference, and Texas Gov. Rick Perry, the head of the RGA, praised before she made her remarks, describing Palin as "a governor who has led her state boldly, inspired a nation with her optimism, her frank talk, her unashamed embrace of bedrock conservative principles. She represents us, Republican governors, as well. And I can assure you, she's just getting started."