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Hotline Sort: Exchange Rate

photo of Julie Sobel
December 17, 2012

Friday was the deadline for states to decide whether to set up health care exchanges under the Affordable Care Act or decline to do so, leaving the task to the federal government. Democratic governors have opted to set up the exchanges or partnerships, but many Republicans have not. With plenty of blue or purple state Republican governors up for reelection in 2014 -- and their decisions on health care a potential campaign issue -- here's a breakdown of where they stand:

Blue or purple state GOP governors who will not set up the exchanges and are up for reelection in 2014:

-- Wisconsin Gov. Scott Walker. "We have a long history of being a leader on health reform issues, and with more guidance and greater state flexibility, our competitive market system would have ensured health insurance coverage to the most vulnerable Wisconsinites without federalization of our market," Walker wrote in a November letter to Health and Human Services Secretary Kathleen Sebelius, per the Milwaukee Journal Sentinel. "Unfortunately, operating a state exchange would not provide the flexibility to meet our state's unique needs or to protect our state's taxpayers."

-- Ohio Gov. John Kasich. "At this point, based on the information we have, states do not have the flexibility to build and manage exchanges in ways that respond to unique needs of their citizens or markets," wrote Kasich in his own November letter to the Obama administration, per the Cleveland Plain Dealer.

-- Pennsylvania Gov. Tom Corbett. "Health care reform is too important to be achieved through haphazard planning," said Corbett, per the Associated Press.

-- Florida Gov. Rick Scott. Though it was no surprise -- Scott has been a vocal critic of the health care law -- the final decision was still unclear heading into Friday's deadline. "At this time we do not have sufficient information on the cost of implementing a state health care exchange to Florida taxpayers, Florida businesses or Florida health insurance purchasers," said Scott spokesperson Jackie Schutz, per the Miami Herald. "We are looking forward to getting more information from HHS and the president."

-- Maine Gov. Paul LePage. "I'm not lifting a finger," he said in an interview with Bloomberg. "We're not going to get involved. We're going to let Mr. Obama do a federal exchange. It's his bill."

-- And New Jersey Gov. Chris Christie, up for reelection next year (and potentially eyeing a 2016 presidential run), also declined to set up the exchange. "We will comply with the Affordable Care Act," he said in a statement, per the Wall Street Journal, "but only in the most efficient and cost effective way for New Jersey taxpayers."

Blue or purple state GOP governors who will set up the exchanges and are up for reelection in 2014:

-- New Mexico Gov. Susana Martinez. "Overall, we never really wavered from the idea that it needs to be a state exchange," New Mexico Human Services Secretary Sidonie Squier told the Associated Press in an interview.

-- Nevada Gov. Brian Sandoval. "I have to look at Nevada," he told the Associated Press. "I'm not going to compare myself to any other governor. I have to look at the consequences of this very complicated law."

Blue or purple state GOP governors who opted for partnerships and are up for reelection in 2014:

-- Michigan Gov. Rick Snyder. Snyder had attempted to set up a state-run exchange, but the GOP-controlled state House stopped it.

-- Iowa Gov. Terry Brandstad. "I continue to have concerns that an intrusive federal exchange would raise costs on individuals and businesses, making it harder for them to create jobs and raise family incomes in Iowa," Branstad said, per the Des Moines Register. "The state of Iowa intends to minimize the federal government's intrusion into the regulation of insurance. We will continue to regulate insurance plans in Iowa and retain control over our Medicaid and Children's Health Insurance Plan eligibility."

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