Refusing to expand Medicaid is a bad option that should be rejected by these holdout governors. It certainly isn't the right course for Govs. Corbett or Christie.
The Supreme Court opinion, written by Chief Justice John G. Roberts Jr., upheld most of the provisions of the Affordable Care Act, yet the court voided financial penalties for states that don't increase their Medicaid ranks. That freed states to leave their Medicaid programs as they are.
Under the original provisions of the ACA, failing to expand Medicaid would cost the individual states millions in federal aid. On the flip side, though, Washington was obligated by the law to cover the full cost of expanding Medicaid for the nation's poorest citizens for several years. The required federal contribution makes it more than worthwhile for the states to use Medicaid to trim their ranks of uninsured.
In Florida, where one in five residents lacks medical insurance, the Medicaid expansion should be like manna. But Republican Gov. Rick Scott, who has built his political reputation on opposing the law, is among the governors who are stubbornly refusing the federal aid.
The GOP push-back against reform is also playing out in setting up the insurance exchanges where individuals and businesses will be able to shop for health plans. A letter to governors from nearly 75 Republicans in Congress urges them not to establish state-run exchanges as a form of protest.
In states that do not create their own exchanges, residents still will be able to shop for the best insurance coverage on a federal exchange. But there's a major advantage in tailoring exchanges to meet the specific needs of each state's residents, health-care providers, and insurers.
Maybe it's just a passing nod to his national political aspirations that has prompted Christie to say he's also thinking of opting out of having New Jersey create its own insurance exchange, as well as passing up any Medicaid expansion. Neither course would be best for the state.
The GOP's continued opposition to the ACA is also contrary to the interests of its traditional political allies in the business community. Just as the uninsured hope the reforms assure them affordable, quality medical care, hospitals, other health-care providers, and insurance firms are eager to see millions more paying customers.
The law's business-friendly aspects apparently must play second fiddle to partisan politics.
