Then, in late January, Doyle’s Republican successor, Scott Walker, issued his own executive order, dissolving the health reform office and replacing it with the Office of Free Market Health Care.
“We view this as a fundamentally different approach than what the past [Wisconsin] administration was doing — and what . . . the Obama administration is pushing,” Walker said in the first interview he has given about health-care reform since assuming office.
Wisconsin’s U-turn, as sharp as anywhere in the country, illustrates how the views of state leaders are shaping the way the health-care overhaul envisioned by Congress will work on the ground. It illustrates, too, the treacherous terrain the Obama administration and congressional Democrats are walking by entrusting states to carry out major parts of the plan now that 29 governors are Republicans, including 18 who — like Walker — have taken office this winter. In Wisconsin, as in five other states, both chambers of the legislature also have just switched to GOP control.
“We’ve gone from one kind of boldness to another,” said Robert Kraig, executive director of Citizen Action of Wisconsin and a leading liberal activist on health care in this university town with its granite-domed state Capitol.
But being dead set against the health law is not proving to be a simple matter of saying no to everything it contains. The new opposition is subtler but no less profound — a process of picking and choosing provisions to embrace or reject, of taking some grants offered by the federal government while spurning others, of striving to kill the law in Congress or the courts while preparing a conservative alternative.
Walker, best known for his effort to demolish rights to collective bargaining for government employees, thinks that the health-care statute is unconstitutional and that the government has no business influencing people’s health-care choices. Doyle’s aides estimated that the law would save Wisconsin $850 million by the end of the decade; Walker’s estimate that it would cost $433 million.
Where Wisconsin is coming from
With states required by 2014 to carry out the law’s core features — among them, widening access to private and public insurance — Wisconsin is in a more auspicious starting place than most. Just 6 percent of its residents lack health coverage, the second-lowest proportion in the country. And over the years, Wisconsin repeatedly has expanded Medicaid, called BadgerCare here, so that an unusually large share of people already has public insurance.
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