Following up on an item from last week, a variety of governors are still making decisions on how (and whether) to create state-based health care exchanges under the Affordable Care Act. States that refuse invite the Obama administration to create exchanges for them.
The latest announcement came from Oklahoma Gov. Mary Fallin (R), who announced yesterday that her state would also refuse to create a health insurance exchange, leaving the job up to federal officials. Oklahoma is now the 17th state to make this decision, and that number may yet grow.
As a rule, when I cover this, I marvel at the irony: many far-right governors who claim to oppose federal control are making a conscious decision to invite more federal control. But let's take the next step and consider why they're doing it.
Some are eyeing higher office and have been warned that cooperating with the Obama administration on health care would ruin their careers. But Jonathan Cohn raises an even more salient point about the larger sabotage strategy.
The subsidies are in the form of tax credits. So Oklahoma officials and everybody else making this argument are essentially calling upon states to block their citizens from receiving federal tax breaks, worth as much as several thousand dollars per person. Aren't conservatives and libertarians supposed to be the party that likes giving tax money back to the people?
Of course, Obamacare critics believe that, by blocking the subsidies, they'll undermine the law's effectiveness and eventually erode support to the point that people clamor for a conservative alternative.
Jonathan Bernstein added, "This is different from typical opposition. It's as if Democrats who opposed missile defense had actively campaigned for contracts to go to the contractors they believed were most likely to produce duds, just so they could eliminate the program after 'proving' that it didn't work.... [O]n health care, it's increasingly hard to believe that they want good outcomes. And that's a lot worse than just typical opposition."