As you know, Bobby Jindal has reacted to the Supreme Court decision upholding Obamacare by declaring defiantly that his state won’t be implementing the law.
“We’re not moving forward with the exchanges,” Jindal said. “Instead, we’re going to do everything we can to defeat President Obama, get rid of ObamaCare.”
This has been greeted mostly as states’ rights bluster designed to appeal to a national conservative audience. But it’s also worth noting that in striking this great blow for Louisiana’s rights, he is basically ensuring that the federal government will come in and build the exchange in his state for him — potentially without his input on how best to tailor it to his own constituents.
The Affordable Care Act requires states to have exchanges. A state has several options: It can build the exchange itself, or it can collaborate with the federal government to build it, or it can let the federal government run it. The state has to tell the feds what path it has decided to take by mid-November. If the state does not want to run its own exchange, or collaborate with the feds to run it, the feds will begin setting up the exchange themselves in January.
If Jindal is serious about not implementing an exchange, the latter course is what will happen under the law, says Kathleen Stoll, the deputy executive director at the pro-Obamacare Families USA.
“If the state hasn’t moved forward, at that point, the feds have to come in to run the exchange to protect the citizens of Lousiana,” Stoll says. “The irony is that Jindal has made a choice to waste time and available federal dollars he could have used to build a state exchange uniquely tailored to his vision and the needs of the people of Louisiana.”
Of course, Jindal is probably banking on Obama losing the election, and Romney fulfilling his promise to repeal Obamacare on day one of his presidency. But that’s a pretty big gamble. Romney, of course, may never make it to the Oval Office. And even if he does, it’s far from clear, given the uncertainties surrounding what Congress will look like and how it will act, if he can even succeed in obliterating the law as promised. If that doesn’t happen, in come the feds.
“He’s playing with the lives of thousands of people in Louisiana,” Stoll says. “The stakes here are high.”
Of course, his state has the right to take this course of action if he so pleases.
Update: To be a bit clearer, the irony is that in the name of states’ rights, Jindal may end up ceding to the federal government some of the control over health reform his state might otherwise have been able to exercise.