Jeffrey H. Anderson

At least for now (although a statewide referendum may be pending), Arizona governor Jan Brewer, a Republican, has succeeded in her efforts to implement a key part of Obamacare in her state.  Brewer has very aggressively — and entirely voluntarily — spearheaded the charge to implement Obamacare’s massive Medicaid expansion on her watch.  She now claims, however, that she’s not really implementing Obamacare — or at least not any significant portion of it.  In a recent interview reported by the Associated Press, Brewer said, “This business that this is Obamacare is a little bit interesting.”  She added, “It is a very, very, very tiny portion of the Obama health care.”  

The Congressional Budget Office (CBO) estimates that what Brewer calls a “very, very, very tiny portion” of the health care overhaul will result in an estimated 11 million new people being dumped into Medicaid under Obamacare, where they’ll receive subpar care at taxpayer expense.  Of the net 30 million that the CBO projects will become newly insured under Obamacare, those dumped into Medicaid will account for more than a third.  (The CBO projects that, even after ten years of Obamacare, another 30 million people will remain uninsured.)  Some of these 11 million people have employer-sponsored insurance today, but the CBO projects that roughly 4 million people will lose such coverage under Obamacare. 

Brewer was under absolutely no legal obligation to implement this key aspect of Obamacare.  As A.P. writes, “Brewer was an early critic of [Obamacare] and among a group of governors who lost the Supreme Court case that fought it, so it was a surprise when she announced she supported [its] Medicaid expansion.”  In fact, it was the Obamacare Supreme Court case that gave Brewer and her state the choice to opt out of the Obamacare Medicaid expansion.  The Court struck down the Obamacare provision that threatened states with the loss of their existing Medicaid funding if they refused to implement the Obamacare Medicaid expansion. 

So Brewer sued and won — at least on this point.  But instead of subsequently working to repeal Obamacare, she has instead worked to implement it.  She fought the Republican-controlled state legislature and succeeded in converting a few Republicans to her — and the Democrat’s — side.  Rather unrepentantly, she now says, “I've led the charge from Arizona to oppose it [Obamacare] — sued, we lost, they won, it’s the law of the land.”

The CBO projects that Obamacare’s Medicaid expansion will cost federal taxpayers about $750 billion over the next decade (2014 to 2023). 

At the other end of the spectrum of Republican gubernatorial leadership, late last night, Maine governor Paul LePage vetoed an effort by both houses of the Maine legislature to implement Obamacare’s Medicaid expansion in the Pine Tree State.