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In a switch, GOP governors back expanding Medicaid

Published on NewsOK Modified: February 8, 2013 at 4:46 pm •  Published: February 8, 2013
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DES MOINES, Iowa (AP) — Once largely united in resisting the Obama administration's new health care overhaul, a growing number of Republican governors are now buying into parts of the system as the financial realities of their states' medical costs begin to counterbalance the fierce election politics of the issue.

This week, Michigan's Rick Snyder became the sixth GOP governor to propose expanding his state's health insurance program to cover more low-income residents, in line with the Democratic administration's strong recommendation. Eleven Republican governors have rejected the idea while a dozen, who have been mostly critical, have not announced a decision.

Although the Democratic president's re-election last fall cleared the way for providing health insurance for millions of Americans who don't have it, many Republican governors have resisted parts of the plan that remained optional. They have been reluctant to expand their Medicaid programs to cover more low-income residents. And many declined to take responsibility for the online marketplaces — called exchanges— that would offer subsidized private coverage to the middle class.

Both would pose costs to the states and also involved cooperating with a larger government role in health care that many Republicans strongly opposed.

However, the federal government's agreement to pay most of the added Medicaid expense, and belief that fewer residents would be showing up at local hospitals without insurance, have begun to break down some governors' opposition.

"Politically, the dynamic may be shifting," said Matt Benson, a senior aide to Arizona Republican Gov. Jan Brewer, who proposed expanding Medicaid last month. "There may be some folks looking at this anew."

Two high-profile Republican governors, Scott Walker of Wisconsin and Rick Scott of Florida, have voiced skepticism about the federal terms but are still considering the option.

Most Democratic governors have supported expanding their Medicaid programs to cover more low-income residents, mainly adults with no children at home, who don't qualify now. With such an expansion, Medicaid would account for almost all of the state's poor. Under the new federal plan, higher earners would be required to get private insurance. Together, the provisions are aimed at sharply reducing the 15% of Americans who are uninsured.

But many Republican governors shrank from taking on any further costs for Medicaid, which has heavily burdened state budgets. The federal government would pay the full cost for the first three years under the new system, but the states would pay up to 10 percent later. Some governors worried that the federal government could decide to trim back its contribution in the future.

The governors now agreeing to opt in and expand Medicaid include Republicans from different regions of the country and different ideological leanings. This has prompted hope among some health care overhaul supporters of more GOP defections. In addition to Snyder and Brewer, Republican governors who support expanding Medicaid include Jack Dalrymple of North Dakota, John Kasich of Ohio, Brian Sandoval of Nevada and Susana Martinez of New Mexico.

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