Pic via sugarfreeglow

Welcome to 2015, Republicans! With the changing of the year, we assume you'll be turning over a new leaf, looking toward the future and leaving behind the petty bickering and toddler-like tantrums that characterized 2014. Ha ha, just kidding, of course.

It seems at least a few in your number are still playing last year's greatest hits:

The Arizona Supreme Court on Wednesday allowed a lawsuit challenging Gov. Jan Brewer's Medicaid expansion plan to move forward, a decision that deals a major blow to the governor's signature achievement just days before she leaves office.

The high court agreed that 36 Republican lawmakers can sue Brewer over the legality of a hospital assessment that funds the expansion plan.

The ruling means Brewer's plan to insure about 300,000 poor Arizonans using a key part of President Barack Obama's health care overhaul could eventually be crippled as she hands the governor's office to fellow Republican Doug Ducey.

Running to the courts might seem extreme, but the Arizona GOP was only driven to this lawsuit because that RINO Jan Brewer actually allowed the socialist scourge of expanded Medicaid to cross the border into Arizona. The real Republicans in the state legislature are just building the dang fence! [contextly_sidebar id="ZlYaeHbNcakxvKj9QiHtciMEBxAFszwi"]

The coalition that Brewer cobbled together with Democrats and turncoat Republicans to pass the expansion is unlikely to be replicated, and for sure could never overcome a veto by the new governor, Doug Ducey, if the state's highest court invalidated the law and it had to be revised. Of course, Ducey's never liked the expansion, so he might save everyone the trouble and drop the state's opposition to the GOP lawsuit. That'd be the responsible thing to do, preserving Arizona's scarce resources to prop up the hospitals hobbled by unsustainable levels of charity care for the uninsured.

It's not that there are no red states taking federal money to expand Medicaid (Kentucky in particular has shown what's possible if states really work it on the health care runway), but turning down the the money has become a thing for certain Republican governors who have at least one eye on higher office. Rick Perry rejected the idea in Texas, which has the highest rate of uninsured residents in the country, but, you know, it's Texas. No governor is going to go along with this Obamacare thing, right?

[J]ust before Christmas, Texas Gov.-elect Greg Abbott signaled that he might be open to a compromise that finally would bring as many as 2 million low-income Texan adults and children under the coverage umbrella. At a meeting with Houston-area state legislators, the Houston Chronicle reported, Abbott asked for more information about Utah's groundbreaking compromise with the feds on Medicaid expansion.

Abbott himself initiated the discussion of Medicaid, "a topic so radioactive in Texas politics that even the mention of it caught the room off guard," according to the Chronicle.

Greg Abbott has not even moved into the governor's mansion yet, and already he's talking about abject surrender to the federal monster. Isn't there anyone left who will fight for the right of Texans to remain shut out of the modern health care system? Think of the jobs that could be lost in the home repossession industry if medical bankruptcy numbers were to take a hit.

Even if weak-kneed "Republicans" like Abbott and Brewer are giving in, Americans who are in danger of being newly insured still have hope. In addition to pledges by Republicans in Congress that they will make it a priority to repeal Obamacare real good, the United States Supreme Court has agreed to hear oral arguments about whether the IRS can give people subsidies for buying insurance on the federal exchange if, for example, they live in a state where Republicans stamped their feet and refused to set up a state exchange.

The Affordable Care Act provides for federal exchanges in states that didn't set up their own, but also says that the subsidies are only good for policies bought on state exchanges. Was this intentional? Probably not. Maybe it was the Republicans what done it, rolling the dice that the wording would make it through! In any case, it's opened the door for the Supreme Court to make health insurance bought on the federal exchange unworkably expensive for many people.

Larry Levitt of the Kaiser Family Foundation adds key context, noting that the biggest enrollment bumps are occurring in big states on the federal exchange, rather than the state ones. “The big numbers of new enrollees are coming from states that are not running their own marketplaces, such as Florida and Texas, where the politics don’t seem amenable to them running their own marketplaces in the event of a Supreme Court ruling against the law.” [...] In federal-exchange states where the largest numbers of people might lose subsidies if SCOTUS rules against the law, state officials might be less likely to then set up their own exchanges to keep the subsidies flowing.

If the Supreme Court rules against extending subsidies to customers in states without their own exchanges, the only hope is that Republican legislators in those states will continue to resist pressure to set up their own exchanges. If only those Republicans can find it in themselves to keep mindlessly opposing anything that could possibly be seen as supporting the evil of Obamacare! In times of trial, they could take a page from Arizona: a little politigation on the state level might be all that's needed to keep people away from those dangerous doctors. Their constituents' lives are in their hands.

[AP/LA Times / WaPo]

You can follow Beth on Twitter. She promises not to try to help you when you're sick.


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