Tim Carney: Health industry pushes GOP states toward Obamacare

[WestVirginiaRebel]

Washington Examiner:

Republicans around the country railed against President Obama's health-care law for four years, but in recent weeks, GOP governors and state legislators have embraced some of the bill's provisions.

How did Republicans learn to stop worrying and love Obamacare?

In a word: industry.

Hospitals, insurers and drug companies have lobbied in state capital after state capital, leaning on Republicans until they agreed to create insurance exchanges or expand Medicaid as Obamacare prescribed.

Idaho has a Republican governor and a Legislature dominated by Republicans, which makes it noteworthy that the state is on the verge of creating an Obamacare exchange.

An exchange is a federally regulated and subsidized virtual marketplace for individuals to buy health insurance. Under Obamacare, states must create these exchanges, or the federal government will.

Oklahoma is forging a third path: Gov. Mary Fallin has refused to set up an exchange, and Attorney General Scott Pruitt is suing to block the federal government from establishing one.

But Idaho Gov. Butch Otter supports a state exchange, arguing that otherwise Idaho would "be at the federal government's mercy in how that exchange is designed and run." But setting up a state exchange doesn't change that.

Obamacare gives the U.S. secretary of health and human services power to impose on exchanges "such ... requirements as the Secretary determines appropriate." A forthcoming Cato Institute report on the exchanges says Obamacare "empowers the secretary to require state-funded exchanges to operate exactly as she would operate a federal exchange."

So why would Idaho Republicans create this exchange instead of following Oklahoma's lead? One driving cause has been the business lobby -- specifically the health-care lobby.

"They lobbied greatly," Idaho state Sen. Monty Pearce, a Republican exchange opponent, told me about the health care sector and the legislation to create the insurance exchange. "They've been lobbying on it for a couple of years. ... They've hired every lobbyist they can get."

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Obamacare's special interests at work.