Published June 24. 2013 4:00AM
The following editorial appears on Bloomberg View.
Three months from now, Americans will get their first look at whether the Afordable Care Act - Obamacare - works. The answer will depend a lot on Republican governors and legislatures - and they should want the law's exchanges to be successful as much as the president does.
The new state insurance exchanges are supposed to start selling health coverage Oct. 1. The idea behind these marketplaces is that allowing apple-to-apple comparisons between health plans will foster competition and lower prices. Most Republican governors and legislatures, however, have resisted running their own exchanges; 19 states have refused to play any role whatsoever.
Continued resistance could hamper an already fraught process. In a report this week, the Government Accountability Office warned that the federal government is behind schedule in building exchanges in states that have refused to do so. This makes it even more crucial that all states pitch in to help.
Why should Republican opponents of the exchanges change tack now? First, there are the crass politics: Many residents who stand to benefit are their constituents. Federal exchange subsidies are available for people earning between 138 percent and 400 percent of the poverty level, or $32,500 to $94,200 for a family of four. According to 2012 exit polls, 42 percent of people with family incomes between $30,000 and $50,000 voted for Mitt Romney; for those earning between $50,000 and $100,000, the share was 52 percent. If Republican governors think stonewalling exchanges hurts only Democrats, they're wrong.
Then there are the economic reasons: States with weak exchanges could become less attractive to businesses.
Finally, most compellingly, there is the human reason - rather, 25 million human reasons. Well-run exchanges will make getting health insurance easier and more affordable.
Obamacare also happens to be the law of the land.
Perhaps the single biggest thing Republican officials could do is simply be ready and willing to address the inevitable hiccups. If states look for ways to stall progress, they'll find them. Conversely, if governors who oppose the law nonetheless direct their officials to cooperate, the exchanges are more likely to survive those hiccups.
Governors could set a positive tone by reminding their residents that the exchanges are coming. Instead of saying the exchanges "are not going to work," as Texas Gov. Rick Perry did in December, they should encourage their constituents to see whether they're eligible for subsidies. It doesn't need to cost the states anything.