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ACA and Healthcare Reform

State Net Capitol Journal: States Leave Partisan Fold On Health Care And The Minimum Wage

By Lou Cannon 

As the nation's capital resumes its customary political gridlock, both political parties are turning to the states to advance national agendas. In the process of doing so, however, they are finding that they are far from united within their own ranks.
Republicans in Washington want states to help them limit the Affordable Care Act (ACA), the singular achievement of President Obama. Many in the GOP would also like states to roll back Common Core educational standards, reduce taxes, challenge labor unions and the Environmental Protection Agency and impose additional restrictions on abortion. Democrats seek advances on gun control and the minimum wage and, in California, on mitigating the impact of global climate change. 
States are in the spotlight because of low expectations from a divided federal government in which Republicans control Congress and Democrats the White House. Some analysts in Washington foresee action on a multi-national trade pact, an issue that crosses party lines. Otherwise, not much is expected from a Congress likely to be feeling its partisan oats and a president willing to use his veto pen. 
Divided government is less of a barrier in the states, particularly for Republicans. After the 2014 midterm elections Republicans control more legislative chambers than at any time since 1929 and hold both the governorship and the legislature in 23 states.(They also control unicameral Nebraska, nominally nonpartisan but Republican in all but name.) 
Democrats control the governorship and both legislative chambers in seven states. 
Division among national and state Republicans is most notable on the Affordable Care Act (ACA), which despite defects will be difficult to dislodge as the law of the land. But in a lawsuit known as King. v. Burwell that the Supreme Court will hear on March 4, Republicans seek to limit the law's reach by denying premium subsidies to recipients who buy health insurance on, the federal health care site. They base their case on the fuzzy wording of a provision in the 1,900-page law, which says that subsidies are available only to Americans who enroll "through an exchange established by the state." Thirteen states and the District of Columbia have their own exchanges. 
To the disappointment of conservatives, only six of the nation's 31 Republican governors filed briefs in support of King v. Burwell. In 2012, when the law's constitutionality was at stake, 28 Republican governors opposed the ACA. In a decision written by Chief Justice John G. Roberts, the high court upheld the ACA's constitutionality except for a provision requiring expansion of Medicaid, the federal-state program that provides health care for the poor and disabled. 
Given this escape hatch, most states with Republican governors did not expand Medicaid, saying it would cost too much once federal subsidies expired. But six GOP governors who did expand Medicaid were easily re-elected, and this seems to have emboldened centrist Republicans to stand up to the right wing of their party on this issue. Republican governors in Wyoming, Utah, Idaho, North Carolina, and Tennessee have said they will try to persuade their legislatures to accept funding for Medicaid expansion. Democratic governors in Pennsylvania and Montana will do the same. All of these legislatures are Republican controlled and generally more conservative than the governors, so the outcome is uncertain. 
Typifying the practical approach of the state governors who want federal funds, Gov. Matt Mead (R) of Wyoming told The Washington Post that he thought the ACA was bad policy and unconstitutional, "but the courts said I was wrong." Mead said since the ACA is law the question is: "How do we as a state make the best of it?" 
Brian Sandoval of Nevada, the only Republican governor to embrace Medicaid expansion from the outset, coasted to victory in November a state where the GOP also won control of the state senate. Joining GOP moderates in the legislature, Gov. Sandoval has proposed tax reform and revamping of education funding and appears to have the upper hand over conservatives opposed to any tax increase. 
On an issue crucial to organized labor, Republicans have high hopes of expanding "right-to-work" legislation, which allows employees to opt out of joining a union. Twenty-four states have such laws, which have been or will be proposed in nine other states this year. 
Even on this issue, though, Republicans are not entirely in synch. In Wisconsin, Gov. Scott Walker, who is said to have presidential ambitions, has called a right-to-work bill pending in the legislature a distraction. With the state facing a $2.2 billion budget gap, Walker has also backed away from talk of cutting income taxes. 
Democrats have internal divisions, too. The gun control movement cheered in November when Washington state voters approved an initiative strengthening background checks for gun buyers and rejected another initiative that would have weakened such checks. In the wake of this rare victory, advocates of "gun safety" — the term now favored by anti-gun groups — are rallying behind a similar initiative that has qualified for the 2016 ballot in Nevada and pushing for initiatives in Arizona, Maine, and Oregon. 
So far, however, relatively few Democratic officeholders have signed on to these gun-safety efforts. Perhaps they remember that two Democratic state senators in Colorado who supported tighter gun laws after the 2012 Aurora movie theater massacre were recalled by the voters following well-financed campaigns by pro-gun groups. 
In contrast, Democrats even in Republican strongholds are rushing to board the bandwagon for increasing the minimum wage. Twenty-nine states now pay more than the federal minimum wage of $7.25 an hour, which President Obama has vainly tried to raise to $10.10. Democratic legislators in Indiana and Kansas have submitted bills in 2015 that would raise the minimum wage in their states. 
This is an issue where the people have galloped ahead of the politicians. Last year 21 states and the District of Columbia raised the minimum wage through legislative or voter action. Except in Congress, where the Republican majority remains opposed, the issue is no longer partisan. Last November, for example, voters in Arkansas, Alaska, Nebraska and South Dakota overwhelmingly approved ballot measures to raise the minimum wage at the same time they were sending Republicans to the U.S. Senate and other important offices. 
At least a residue of bipartisan support remains for Common Core, the national education standards adopted by 46 states and the District of Columbia over the past few years, even though conservatives opposed to the plan seek to make it a partisan issue. Among prospective Republican presidential candidates, only Jeb Bush supports Common Core. Opposition from conservatives and community groups led three states — Indiana, Oklahoma and South Carolina — to drop out of the program. 
Climate change is another, and more partisan, front. National Republicans appear largely aligned with their state counterparts in contesting the reach of the Environmental Protection Agency, which in the absence of new legislation has proposed state-by-state targets for reducing carbon emissions. A dozen states, cheered on by Republicans in Congress, have challenged the proposed EPA regulations in federal court. 
The culture wars also continue in the states, although partisan lines have blurred on same-sex marriage, now legal in 36 states. This represents a sea change in the law and public attitudes; a decade ago Massachusetts was the only state where same-sex marriage was legal. 
Abortion is another matter. Since Republicans flexed their muscles in the 2010 legislative elections, GOP-controlled states have passed more than 200 restrictions on abortion and more are likely this year. Measures to ban abortions after 20 weeks of pregnancy are given strong chances of passing in South Carolina, Wisconsin and West Virginia. Tennessee voters in 2014 gave the legislature powers to regulate abortion. State House Speaker Beth Harwell (R) said her chamber will take up measures requiring mandatory counseling, a waiting period and stricter inspection of abortion clinics. 
So overall, it's fair to say that recognizable party lines on several issues continue to exist in Washington D.C. and many states. But voters and those who represent them in state legislatures are not automatons who dial up prepared meals from partisan menus. On the vital issues of education, health care, and the minimum wage, there's still plenty of independent thinking in the states.

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