Here's where the real vulnerability in Obamacare has always been: with the states and their inordinate power as heatlh insurance regulators. The ability of Republican state governments to undermine the law has always been a possibility, and always been a concern because of the core structure of the law being state health insurance exchanges. And now, state level Republicans are
seeing victories. Two organizations, one in Ohio and one in West Virginia, have dropped out of a key program that would help enroll millions of the uninsured.
Cincinnati Children’s Hospital Medical Center has turned back a $124,419 grant to enroll uninsured people at their main hospital and two satellite locations. Spokesman Terry Loftus said that the hospital decided to decline the funding after Ohio enacted new restrictions in late July that significantly limited who could participate in the program. [...]
West Virginia Parent Training and Information also sent back an award, theirs for $365,758. It was meant to fund “outreach to people with disabilities, people with limited English proficiency and/or limited literacy, people of low socioeconomic status, and people in rural areas,” according to a federal description of the project. [...]
West Virginia attorney general Patrick Morrissey has been a leading critic of the navigator program. He organized in August a letter signed by 13 attorneys general to Health and Human Services that described the navigator program as a “security disaster waiting to happen.” [...]
Morrissey also sent a separate letter to the West Virginia Parent Teaching and Information to solicit specific information from the group in his state. He included eight detailed questions that asked the group to specify whether their navigators would “inform consumers of their data privacy rights” and whether they would require criminal background checks.
The new Ohio law prevents any organization that negotiates with health insurers to participate in the navigator program, so hospitals aren't eligible to participate in Ohio. In the West Virginia case, it's obviously a much more direct and specified intimidation campaign by a state official against individual programs.
According to the Commonweath Fund, 17 states have passed various kinds of legislation to make this outreach effort as difficult for the administration as possible. Because more people having health insurance is the worst thing in the world and they must stop it.