The party remains fully committed, without dissent, to a full-on boycott of any measures to help the law function in any way... The Republicans’ Obamacare boycott will increasingly render the party useless for an expanding list of constituencies. Yet the Obamacare boycott remains a policy of universal agreement within the party.
This isn't true. Well, maybe it's true in Congress.
But the Republican Party has high-profile dissenters from the obstruction-only consensus: Nine Republican governors who are working to implement the Medicaid expansion. This is the provision that offers Medicaid to everyone making up to 133% of the federal poverty line, accounting for about half the expansion of insurance coverage in Obamacare.
Some Republican governors who back the expansion, like Chris Christie (N.J.) and Susana Martinez (N.M.), are working with Democratic state legislatures that are eager to participate. And Rick Scott (Fla.) has been unsuccessful in getting the expansion through his Republican-held legislature.
But as many as four totally Republican-held states may end up cooperating with the President. Two governors, Jack Dalrymple (N.D.) and Jan Brewer (Ariz.), have already managed to twist arms and get Republican-led legislatures to pass the expansion. And two more, John Kasich (Ohio) and Rick Snyder (Mich.), are still trying.
Their reason is easy to understand: The federal government pays for the entire expansion in its first few years, and then 90% of it from 2017 onward. Turning down the expansion means turning down nearly free money the federal government wants to send to your state. It's a high price to pay to spite the president and pander to the conservative base.
Refusing to take the expansion is also likely to cause hospital closures. That's because Obamacare cuts payments to hospitals that compensate them for treating the uninsured, on the grounds that many of the current uninsured are supposed to end up on Medicaid. That's a political disaster waiting to happen in 2014 and 2015 for Republicans who won't take the expansion.
Chait's right to call out the unsustainability of the Republican strategy to obstruct Obamacare at every turn. But the Republican "consensus" on it isn't just set to crack under industry-group pressure; at the state level, it's already falling apart.
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