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Obama supports flexibility for states on health law

President Barack Obama speaks during a bipartisan meeting of governors at the White House on Monday.

Associated Press

President Barack Obama speaks during a bipartisan meeting of governors at the White House on Monday.

WASHINGTON — Looking for some goodwill from the nation's governors, President Barack Obama said Monday that he's willing to bend a bit to help them deal with their budgetary problems stemming from health care costs — and the political heat rising from his 2010 law to expand health care.

Obama, addressing the National Governors Association, said he supports a move to let states design their own health care systems starting in 2014 with waivers from provisions of his 2010 Affordable Care Act, so long as those state systems meet the law's goals. The existing law wouldn't allow state waivers until 2017.

"It will give you flexibility more quickly while still guaranteeing the American people reform," Obama told the governors. "If your state can create a plan that covers as many people as affordably and comprehensively as the Affordable Care Act does — without increasing the deficit — you can implement that plan. And we'll work with you to do it."

The 2014 date is when many of the act's central provisions take effect, including requirements that most individuals obtain health insurance and that employers of a certain size offer coverage to workers or pay a penalty.

The president vowed as well to work with a bipartisan panel of governors to find alternate ways to reduce Medicaid costs without hurting services to those who need it, if the governors can come up with recommendations that meet his qualifications. "If you can come up with more ways to reduce Medicaid costs while still providing quality care to those who need it, I will support those proposals as well."

Obama's concessions followed weekend appeals from governors of both parties for federal help in reducing the budget-crushing costs of Medicaid, whose expenses are split between federal and state governments. The governors were attending their semiannual conference here.

Obama said that his 2010 health care law already recognizes that states need flexibility to do things their way. "Alabama is not going to have exactly the same health needs as Massachusetts or California or North Dakota. We believe in that flexibility," he said.

Legislation to speed state waivers under the health care law is sponsored by Democratic Sens. Ron Wyden of Oregon and Mary Landrieu of Louisiana and Republican Scott Brown of Massachusetts.

"I think that's a reasonable proposal. I support it," Obama said.

Meanwhile, Obama's health care law faces legal challenges from at least 27 states. Offering states more flexibility in meeting its terms could at least cool the public debate, though it's unlikely to end court challenges to the law.

Since Democrats' losses in November's elections and the Republicans' takeover of the House of Representatives, Obama has been trying to show a greater willingness for bipartisan compromise.

Public opinion polls generally show that the country remains divided over the health care act, which seeks to insure 32 million Americans by requiring coverage and offering subsidies to make it affordable. But the polls show that only a minority favors repealing the entire act, as the Republican-led House voted to do earlier this year.

In the courts, federal district judges have issued contradictory opinions that are now under appeal. Florida's challenge, filed in Pensacola, is backed by 25 other states. In January, Judge Roger Vinson ruled the law unconstitutional. The Supreme Court is ultimately expected to decide whether Congress' constitutional authority is broad enough that it can require citizens to purchase a commercial product like health insurance.

The governors' conference in Washington comes as lawmakers in Congress are working to avoid a federal government shutdown because of a partisan dispute over spending, and as a fight in Wisconsin over collective bargaining for public employees threatens to weaken public employee unions nationally.

The president said that "I believe that everybody should be prepared to give up something in order to solve our budget challenges" but that "I don't think it does anybody any good when public employees are denigrated or vilified or their rights are infringed upon."

Information from the New York Times was used in this report.

Opting out, with conditions

On Monday, President Obama said he supports allowing states to opt out earlier from various health care requirements if they could demonstrate that other methods would allow them to cover as many people, with insurance that is as comprehensive and affordable, as provided by the new law. The changes also must not increase the federal deficit.

If states can meet those standards, they can ask to circumvent minimum benefit levels, structural requirements for insurance exchanges and the mandates that most individuals obtain coverage and that employers provide it. Washington would then help finance a state's individualized health care system with federal money that would otherwise be spent there on insurance subsidies and tax credits.

Obama supports flexibility for states on health law 02/28/11 [Last modified: Monday, February 28, 2011 9:52pm]
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