small but growing number of prominent, Republican governors — including Mitch Daniels and Haley Barbour — are taking the lead to shape a key component of the health care overhaul their party fought so hard to kill.
It’s a delicate balancing act for Republicans who, on the one hand, oppose federal health reform, even challenging its constitutionality in federal court, and, on the other hand, are pragmatically trying to control as much of the implementation process as they can.
The big picture is that, while there’s an ideological divide, many governors see the exchange as an empty vessel they can shape in their own image,” says Ian Morrison, an independent health policy consultant in California. “Republican governors like the idea of more commercial insurance.”
Another crucial factor at play: If states don’t set up their own exchanges by 2014, the federal government will come in and do it for them.