By Tom Curry, National Affairs Writer, NBC News
The debate over Obamacare's debut shifted to the state level Sunday with two governors describing their state's experiences and clashing over the value of the Affordable Care Act.
Ohio Gov. John Kasich, a Republican, defended his decision to expand the state’s Medicaid program as part of the health care overhaul, despite opposition from the state’s GOP-controlled legislature, saying on NBC’s Meet the Press Sunday “Ohio gets a good deal.”
Kasich explained that his state will get $14 billion of federal money over the next several years to expand Medicaid coverage for the mentally ill, veterans, drug abusers and other low-income people who need medical treatment.
“I’m not going to ignore the mentally ill and I’m not going to ignore the drug addicted or veterans or very (hard) working poor people on my watch,” Kasich said, but that “doesn’t mean I embrace Obamacare.”
Kasich reiterated his broader opposition to Obamacare, saying, “The problem is Obamacare doesn’t control costs… it’s going to drive up the cost for the vast majority of Ohioans. It threatens the ability of small business to grow beyond 50 employees.”
To do his Medicaid expansion and cover about 275,000 low-income people in his state, Kasich used an obscure body called the State Controlling Board to go around the legislature.
Nationwide, the Medicaid expansion is a crucial part of Obamacare, with up to 17 million uninsured people potentially eligible to be covered. But last year’s Supreme Court decision on Obamacare gave states the option to not take part in the Medicaid expansion and 25 states – including many states with GOP governors -- have chosen to not do so.
Ohio is also one of the 36 states which is not setting up its own state-supervised health insurance marketplace for the uninsured under the Affordable Care Act; so the eligible uninsured in Ohio will purchase insurance through the federally run marketplace which has been plagued by software problems which have blocked many people from enrolling for coverage.
Kentucky Gov. Steve Beshear, a Democrat, said on Meet the Press Obamacare will work if given enough time.
“The advice I would give the news media and the critics up here is: take a deep breath,” Beshear said. “This is a process. Everybody wants to have a date where they can declare victory or defeat, or success or failure. That’s not what this is going to be all about. It took us about three years to get Medicare really working.”
He predicted, “People are going to sign up for this; it will take us a while to get it in process. But I’ll guarantee you we’re going to make it work because it is good for the American people and it’s good for Kentucky.”
Beshear’s state is one of only 14 states that is running its own insurance marketplace under the new federal health care law.
He said, “We’ve signed up over 26,000 people so far.” But NBC’s David Gregory pointed out that in Kentucky the new insured were mostly low-income Medicaid enrollees, not necessarily the young and healthy people who would in theory help make the Obamacare expansion financially viable.
And Beshear did acknowledge that so far 21,000 of the newly covered were in Medicaid and 5,000 were enrolled in health insurance plans under Obamacare.
Beshear explained that it is “a lot quicker” to get an insured person enrolled in Medicare than to get him or her enrolled in a new insurance plan offered in the Obamacare exchanges.
Obama has assigned Jeff Zients, the chief White House economic adviser and his former acting budget chief, to fix the Obamacare enrollment website.
Zients told reporters Friday that he is confident that “by the end of the November, healthcare.gov will be smooth for the vast majority of users.”
On Fox News Sunday, another governor – and a potential 2016 GOP presidential contender – Louisiana’s Bobby Jindal said, “I think they'll eventually fix the website, but let's remember, this is the easy part. You know, the real critical issue is when it comes time to schedule your grandmother's cancer surgery, what's going to happen then?”
The Louisiana Republican said, “This is an incompetent rollout, but it's symptomatic of a liberal ideology that believes government should be running our healthcare.”
Jindal argued that pressure would grow on President Barack Obama to delay the penalties for those who don’t purchase insurance coverage.
And he predicted that as the law’s effects become clear, people will turn sour on it. “You're seeing fewer people sign up, more and more plans dropping out, hundreds of thousands of Americans, maybe even over a million Americans, learning they're not going to be able to continue in their current insurance plan. As Americans find out premiums are higher than they were promised, I think you're going to see more and more frustration build, more and more Democrats and Republicans calling for delays, for repeals.”