Cracks form in GOP opposition to HIX

January 23, 2013 in Medical Technology

By Phil Galewitz, KHN Staff Writer

This story was produced in collaboration with

Gov. Phil Bryant and Insurance Commissioner Mike Chaney have known each other for 30 years and call themselves friends.Now, though, a wedge has come between the two elected Republicans — President Barack Obama’s health law.

Mississippi Gov. Phil Bryant and Insurance Commissioner Mike Chaney (Photos by USDAgov via Flickr and Mississippi Insurance Department)

Bryant is trying to stop Chaney from creating a critical feature of the Affordable Care Act – an online health insurance marketplace that will allow  an estimated 250,000 Mississippi residents to shop for coverage and find out if they qualify for government subsidies or Medicaid, the state-federal health program for the poor.

Their dispute, in a state whose population is among the nation’s poorest and least healthy, is an example of a growing split among Republicans over whether to continue resisting the controversial law. Two months ago, Republican opposition was nearly uniform across the country.  But cracks are appearing and they will widen, predicts Larry Jacobs, director of the Center for the Study of Politics and Governance at the University of Minnesota. “The arc of partisan fever is beginning to recede and pragmatism is beginning to come to the fore,” he says.

Arizona Gov. Jan Brewer, one of the law’s most vocal opponents, shocked the GOP-controlled legislature on Jan. 14 when she backed the health law’s optional Medicaid expansion. Brewer became the fourth Republican governor and 23rd overall to embrace extending Medicaid to cover residents earning up to 138 percent of the federal poverty level ($32,000 for a family of four). The other GOP states to sign on are Nevada, New Mexico and North Dakota.

Most states are expected to decide on expanding the program by late spring.  As many as 17 million people would become eligible for Medicaid if all states participate.

Mississippi was one of four Republican states and 17 overall (plus the District of Columbia) that applied to the federal government in December to establish a state insurance marketplace, or exchange.  The other GOP states were Utah, Idaho and Nevada. States that don’t set up an exchange will have one created by the federal government.

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