In an effort to keep the faith, the Republican governors who have accepted Medicaid funds have emphasized their continued opposition to Obamacare overall. Florida opted against running its own insurance marketplace next year, for example.
“It is not a white flag of surrender to government-run health care,” Scott said on Wednesday. “I’ve never been a supporter of the Affordable Care Act,” Brewer noted in her Medicaid expansion announcement in January. But the Medicaid expansion is the most painful part of the health reform law for governors to resist, both financially and politically.
The Obama administration, for its part, has been trying hard to persuade governors to come on board. Early after the Supreme Court decision, officials clarified that there would be no deadlines for Medicaid expansion and that it wasn’t permanent. Health officials have also been offering inducements, by humoring requests for changes to existing state Medicaid programs. On Wednesday, Scott declared victory on a long-sought approval for a plan to move more Medicaid recipients into private health plans. Ohio Gov. John Kasich, another Republican, has said that the White House has made promises that it will approve his reform plans, too.
“If you take out the partisanship and the tea party and you look at the facts, as long as you believe the federal government will follow through on its commitment, Medicaid expansion makes sense,” said Michigan pollster Edward Sarpolus, who has researched the issue and tracks the govenor’s approval ratings. “He [Snyder] appears to be conservative, but he’s much more of a pragmatist.”
Notice how some of the Republican governors acquiescing to bigger Medicaid programs — even those who campaigned on their party’s traditional anti-big-government, pro-free-enterprise themes — are adopting the bleeding-heart rhetoric frequently associated with liberal Democrats.
Scott made it personal by talking about his late mother’s struggles to raise five kids, including one son with a hip disease. So did Kasich in his State of the State speech last month, invoking his religious faith and lamenting the plight of addicts and mentally ill people living on the streets.
“For those that live in the shadows of life, those who are the least among us, I will not accept the fact that the most vulnerable in our state should be ignored,” he said, adding a plea to lawmakers to “please examine your conscience.”
These appeals are a departure from the tough talk associated with Republican presidential nominee Mitt Romney, who suggested “self-deportation” for illegal immigrants and was caught in a private fundraiser dismissing the nearly half of Americans who depend on some form of government assistance as freeloaders.
“There no question that Republicans should look at the kind of language Kasich is using as a model and an effective way to communicate because the party’s brand does need some work,” said Ohio-based Republican strategist Curt Steiner, who worked as chief of staff for former Gov. George Voinovich.
Another reason for Republicans seeking to broaden the party’s tent to reconsider the health care law: It’s popular in the Hispanic community, the fastest growing part of the electorate. An ImpreMedia/Latino Decisions poll on the eve of last November’s election found that 61 percent of respondents thought Obamacare should stand and 66 percent thought the federal government should make sure everyone has health insurance.
After seven out of 10 Hispanic voters rejected Romney in November, Republican Party leaders are increasingly calling for better outreach and praising Capitol Hill for taking up immigration reform.
But Medicaid expansion is not a done deal in Florida and other states where Republican-led legislatures are leery of conservative activists who remain hostile to Obamacare. It’s the same chasm between the pragmatic political establishment and the more ideological grassroots that’s emerging in the national debates over the federal budget, immigration reform, and other social issues. The Wall Street Journal editorial board, acting as a top enforcer of the anti-Obamacare orthodoxy, has slammed Scott, Brewer, and other state executives who are cooperating with the president.
With one recent poll pegging Scott’s approval rating at just 33 percent, it’s even possible that the sitting governor could draw a primary challenge.
“The grassroots hasn’t brought out the pitchforks and torches out yet, but they certainly want an explanation from Governor Scott,” said Peter Feaman, Florida’s Republican national committeeman. “I’m getting e-mails expressing serious concerns and I think the grassroots will put a lot of pressure on the Legislature to stay strong.”
CORRECTION: The graphic accompanying this story originally referred to Medicare expansion. The states are considering expansion of the Medicaid program, not Medicare. The graphic has been updated.
This article appears in the Feb. 22, 2013, edition of National Journal Daily.
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