At least nine Republican governors, including Virginia's Bob McDonnell, are still undecided about whether they will establish state-controlled healthcare insurance exchange programs under Obamacare or let the federal government do it for them.
In an interview Monday with Fox News' Greta Van Susteren, McDonnell said he was still trying to get detailed information from the Obama administration on rules and cost estimates for setting up a state exchange. Without it, he said Virginia would likely default to the federal government and allow the Department of Health and Human Services to establish an exchange for the state.
Fourteen other Republican governors have already made that decision, citing either their outright disdain for Obamacare or concerns about the costs of setting up exchanges, which are designed to give consumers more options in searching for affordable insurance.
Governors now have until Dec. 14 to decide on their own exchanges, a federal exchange, or a combination of both.
"Republican governors would rather do things at the state level, rather than have the federal government do it," McDonnell said. "But the problem is we've been asking for months in writing for information and the rule-making to give us the information about how the state and federal exchanges are going to be set up. And we still have a great absence of information."
"If they're not going to provide the information . . . the only thing to do is to default and let the federal government set it up," he added. "Either way, you comply with the law."
McDonnell said he's worried primarily about costs and the possibility that state could "get stuck with the price tag" for setting up an exchange "if the federal government doesn't completely fund it."
"It's a great concern with already an over-burdensome Medicaid program that is killing most governors' budgets around the country," McDonnell said. "So we want to know what we're getting into. If there's no answers, we're going to have a federal exchange. I can't recommend that we set [a state exchange] up in Virginia."
The governor described Medicaid as a "huge budget buster" to begin with and he suggested that Virginia may not be able to expand the program to cover more people as called for under Obamacare without some "dramatic" reforms to help reduce costs.
"What we're afraid of is if we agree to do some of these things on our own, they're going to stick us with the price tag at the federal level, not provide the resources, and that's not a good value proposition for the people of Virginia or any other state," he said.
Oklahoma Gov. Mary Fallin made the same point in a separate interview with Van Susteren.
"We said, 'Thanks, but no thanks,'" she said, citing opposition to Obamacare that Oklahoma voters chose to put in the state constitution.
"So we're going to default [on setting up an exchange program] and say, you are forcing something upon the state of Oklahoma that we did not support, we still do not support," Fallin added. "It is a federal law so we'll let the federal government do their thing, do what they're going to do in Oklahoma."
Like McDonnell, Fallin said she worries that the United States "is heading off a fiscal cliff" and we won't be able to help the states fund the exchange programs, or other provisions of Obamacare for that matter.
"I don't think they're going to have the money to do it in the first place," she told Van Susteren, adding that she's bothered as well by a lack of information and guidelines on how the exchanges should be set up and administered.
All of that should have been settled two years ago when the Affordable Healthcare Act was passed, she said.
"Frankly, if you don't know what the rules are, how can you set up the exchange on the promise they are going to do it right later when, frankly, they don't have a history of doing things right?" Fallin said.
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