Mediaboss Marketing

As President Obama fights in Congress and the courts to preserve the nation's sweeping healthcare law, the Affordable Care Act faces still another threat to its viability: Republicans in statehouses, many bucking governors of their own party eager to accept its flow of federal dollars.

When a group of Republican governors filed suit to overturn Obama's signature achievement, Wyoming's Matt Mead was among them, arguing the legislation was a vast overreach that violated the Constitution and trampled the right of states to set their own policies.

But after the U.S. Supreme Court rejected that argument, Mead decided it would be foolhardy to pass up tens of millions of dollars the act provided to expand coverage for Wyoming's uninsured adults.

"We have fought the fight," Mead told lawmakers last month in his State of the State address. "We've done our best to find a fit for Wyoming. We are out of timeouts, and we need to address Medicaid expansion."

That argument failed to sway lawmakers in Wyoming's GOP-run Senate, which voted 19 to 11 to reject Mead's proposal; many of the opponents, said Phil Nicholas, the Senate president, had campaigned on a promise to block Medicaid expansion.

A similar dynamic is playing out in legislatures across the country, including Arizona, Florida and Utah, where conservative lawmakers remain a formidable hurdle to momentum building behind the Democratic goal of guaranteeing universal coverage.

Indeed, they have proved far more effective at thwarting the 2010 healthcare law than their Republican counterparts in Washington, who have voted more than 50 times to repeal all or part of the program many call Obamacare, largely to no avail.

Earlier this month, in Tennessee's GOP-led Senate, a committee rejected a proposal to extend Medicaid coverage despite a strong push by the state's Republican governor, Bill Haslam, and waivers from the Obama administration meant to allay conservative concerns.

"I said from the very beginning it would be difficult," Haslam told reporters after his plan was shot down. "I think what you saw today is a measure of just how difficult."

The role of state lawmakers could become even more important depending how the Supreme Court rules this spring in another challenge to the healthcare law. Opponents are seeking to end the public subsidy for residents in as many as 37 states where the federal government operates the marketplace for health insurance.

Original post:
Republican lawmakers hold the line against Obamacare at state level