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How Medicaid expansion will play in 2016 (or 2020)

at 02:38 PM ET, 07/05/2012

Right now, opposition to the Affordable Care Act is high, and Republicans are competing over who can criticize it the most. But how will the law play in a few years? The reaction of Republican governors who might run for president in 2016 (or 2020 if Mitt Romney wins this November) provides some clues.

While some Republican governors have declared their intention to reject the funds, others have been more cautious. The Medicaid expansion doesn’t go into affect until 2014. Not only will it offer states more money for the uninsured, the measure has signficant support from the hospital industry.


Nikki Haley won’t take funds to expand Medicaid. (Steve Jessmore - AP)

The Supreme Court ruled that state governments can opt out of the law’s Medicaid expansion, which covers all people with incomes at 133 percent of the federal poverty level or less. The federal government will pay the difference between current state coverage and the new standard until 2020, when it will cover 90 percent.

On July 1, South Carolina Gov. Nikki Haley made her position known via Facebook.

“South Carolina will NOT expand Medicaid, or participate in any health exchanges,” she wrote. “I WILL do everything I can to get Mitt Romney elected and work to strengthen our Senate so that we can repeal this unAmerican policy.”

Louisiana Gov. Bobby Jindal has been one of the most vocal opponents of the law and all its aspects since the Supreme Court ruling.

“I don't think it makes sense to do those,” Jindal said on “Meet the Press” the Sunday after the ruling. ”I think it makes more sense to do everything we can to elect Mitt Romney to repeal Obamacare.”

Gov. Scott Walker (R-Wis.) told reporters after the ruling that he too would wait to see whether the law is repealed: “For us to put time and effort and resources into that doesn’t make a lot of sense.”

Others gave themselves a little wiggle room.

Virginia Gov. Bob McDonnell is noncommittal. He opposes the law and called the expansion an “unfunded mandate.” But has not explicitly said he would reject the funds, and he told reporters last week that he didn’t expect every Republican governor to do so. “Most governors are going to do what they think is best for their states,” he said.

Nevada Gov. Brian Sandoval told a local news station that “as I sit here today, it wouldn’t be my intention to opt in,” but that he needed more information to make a decision.

And New Jersey Gov. Chris Christie said Medicaid is “pretty well expanded” in his state and that the ruling that states could opt out was “a ray of sunshine on an otherwise cloudy day.”

Right now, Republicans want to form a unified front against the health-care law and the president who signed it. But after the election, it won’t be surprising if some of these hedging 2016 contenders take the funds after all. Pledging not to do anything until voters weigh in is a good way to play both sides.

 
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