GOP governors: No enacting health law until after November

Republican governors are vowing not to enact President Obama's healthcare law while there is still a chance for conservatives to sweep elections in November. 

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On a conference call with reporters, Govs. Bob McDonnell (R-Va.) and Bobby Jindal (R-La.) emphasized that their focus was on the election, not yielding to "ObamaCare" despite the fact that the Supreme Court upheld it Thursday. 

"We're not going to start implementing ObamaCare," Jindal said. "We're working to elect Mitt Romney." 

The ruling created a dilemma for states by making the law's expansion of Medicaid optional. Governors can now choose not to cooperate — and not face a penalty — but that means turning down the federal government's offer to foot the bill.

As written, the Affordable Care Act would have punished states that refused to expand coverage under Medicaid by pulling all federal funding for their program.

That approach was strongly criticized in Thursday's majority opinion from Chief Justice John Roberts.

"The financial 'inducement' Congress has chosen is much more than 'relatively mild encouragement' " to expand Medicaid, Roberts wrote. "It is a gun to the head."

States that still agree to expand their Medicaid rolls under the law will help to pay for the program's growth starting in 2016. On Friday, McDonnell called this "another long-term unfunded mandate, another major budget-busting burden."

The Virginia governor is considered a potential GOP vice presidential pick. He is also head of the Republican Governors Association.

"The priority right now is to elect a new president and a new Senate so that this [health] law can be repealed," he said. "Most of the Republicans governors would agree with what Gov. Jindal and I have said."

Past estimates have said that Medicaid expansion would provide healthcare access to an additional 17 million poor Americans — those who earn 133 percent or less of the poverty level every year.

"States will now have to make a series of decisions moving forward," Matt Salo, of the National Association of Medicaid Directors, said in a statement Thursday. "Those include the political, fiscal, and policy calculations of whether or not this particular expansion makes sense.

"They will also have to factor in what may happen in the wake of the November elections," he said.

Governors will face similar concerns as they weigh if and how to create the law's insurance exchanges.

Thirty-four states and the District of Columbia have received federal grants to assemble their own exchanges so far, the Department of Health and Human Services said in May.

For states refusing to move forward, the federal government will eventually step in to do the work itself.

Several Republicans have said those states are holding out for November.

"I think [those states] will be looking for what happens in the November elections, as well," House Energy and Commerce Committee Chairman Fred Upton (R-Mich.) told Modern Healthcare.

States' choices — especially on the Medicaid expansion — are also likely to affect the law's total costs.

Other conservative leaders have called for a wait-and-see approach.

On Friday, Rep. Michele Bachmann (R-Minn.) told CNN that she is working with Sen. Jim DeMint (R-S.C.) and Rep. Jim Jordan (R-Ohio) to contact every governor and urge them to stop implementing the law.

"We are very confident that after the election, we will repeal ObamaCare," she said.

With reporters, McDonnell stressed that a former governor like Romney would make a better president than Obama, a former senator. He said that Obama holds an "ideological view of healthcare — not a practical view of governing in the states."

Separately, the conference call created a small stir online after Jindal half-articulated the term "ObamneyCare" while referring to the law.

The coinage was favored by Republicans who opposed Romney in the presidential primaries, including Jindal, who supported Texas Gov. Rick Perry (R).