WASHINGTON -- While other Republican governors are starting to back away from their opposition to implementing a key part of President Obama's health care law, Louisiana Gov. Bobby Jindal said Tuesday that he's not reconsidering.
"We are not implementing the exchange," Jindal said in a phone interview on Tuesday night.
And even though U.S. secretary of health and human services Kathleen Sebelius has extended by one month a Nov. 16 deadline for states to notify the federal government of their intentions regarding exchanges, Jindal said Louisiana will be sending in their rejection letter this Friday.
The Affordable Care Act mandated the creation of exchanges in each state, which will serve as clearinghouses in which private insurance plans can compete for business in a central database as long as they meet certain government-specified criteria, and in which residents can apply for subsidies to lower costs. If state governments do not agree to set up an exchange, the law says that the federal government will step in and do it.
"They're going to get another communication confirming to them that we're not going to be implementing the exchange," he said. "It doesn't make sense for us to do that."
Jindal's stance is in contrast to Florida Gov. Rick Scott (R). Scott was a vocal critic of the state-based exchanges prior to Obama's reelection on Nov. 6, but on Tuesday he told the Associated Press that he is ready to have a "conversation" with Washington about moving forward with the exchange.
The two governors' different positions are indicative of their circumstances. Jindal is in his second term, having been reelected overwhelmingly a year ago, and is positioning himself for a presidential run in 2016. Scott, on the other hand, is in his first term and up for reelection in 2014, and he has so far been an unpopular state executive.
Jindal is in Las Vegas this week for the Republican Governors Association annual conference. The son of Indian immigrants is set to take the reins of the organization in 2013, a sign of his growing stature within the party. And in the early days of the 41-year old governor's star turn, he is striking a confrontational tone toward the president, at least regarding health care.
"When it comes to health care policy going forward, I think the administration has an opportunity," Jindal said. "This president said he was going to change the partisan tone in Washington, and we know what he embarked on: a very partisan stimulus spending bill, he embarked on a very partisan health care bill. I think now that he's won reelection he's got a chance to work with governors."
He continued, "We are certainly going to go to the president and give him a chance to actually be bipartisan and give him a chance to give us the flexibility to bring more market-based competition and ideas into health care programs, and I hope he'll work with us to do that."
Jindal specified some ways in which health care programs could become more market-based.
"I think this president has a chance to introduce -- on the Medicaid side of it certainly -- to update a 1960s-era program that can truly make it more market based," he said. "For example, there are some things that Mitch Daniels wanted to do in Indiana in terms of HSA's [health savings accounts]. There are some things they could do in terms of benefit variability. There are things you can do with premium support within the Medicaid program, that can make it a lot more flexibile, market-based and more efficient and conducive to the needs of individuals."
Support for health care premiums within Medicaid was the linchpin of Rep. Paul Ryan's (R-Wis.) Medicare reform proposal, most of which Republican presidential nominee Mitt Romney adopted.
Jindal is seeking to preserve conservative solutions to health care, and to position Obama as the intransigent one if the president does not allow governors to experiment with best practices in their own states.
"A lot of those reforms, the administration would have to decide whether to allow us to do them or not, because a lot of those reforms will require waivers and other approvals from the CMS, the federal government," Jindal said. "I think it'd be good for [Obama] and his administration and the county, but obviously he's going to have to decide whether he wants to work with us or not."
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He's been quiet since the election, but it's clear the <a href="http://www.usatoday.com/story/news/politics/2012/11/10/rubio-immigration-presidential-run/1695791/">GOP is looking to their top Latino star</a> to deliver more votes next presidential election. Rubio is the obvious choice to make the Republican Party's case to Hispanic voters, but will he <a href="http://blogs.miaminewtimes.com/riptide/2012/11/sorry_bill_oreilly_marco_rubio.php">remain opposed to a path to citizenship</a> for the undocumented?
The conservative Fox News commentator, once known for his criticism of anything resembling "amnesty," had this to say after last week's election: "We've gotta get rid of the immigration issue altogether. It's simple for me to fix it. I think you control the border first, you create a pathway for those people that are here, you don't say you gotta home. And that is a position that I've evolved on. Because you know what -- it just -- it's gotta be resolved. The majority of people here -- if some people have criminal records you can send' em home -- but if people are here, law-abiding, participating, for years, their kids are born here... first secure the border, pathway to citizenship... then it's done. But you can't let the problem continue. It's gotta stop."
Before the election, House Speaker John Boehner didn't think Marco Rubio's conservative alternative to the DREAM had a chance in the lower chamber. After President Obama trounced the GOP among Latino voters last week, <a href="http://www.nytimes.com/2012/11/09/us/politics/boehner-confident-of-deal-with-white-house-on-immigration.html">Boehner now says he's "confident"</a> Congress can work out a deal.
Texas' <a href="http://www.newyorker.com/reporting/2012/11/19/121119fa_fact_lizza?currentPage=all">Tea Party-backed, Cuban-American U.S. Senator Ted Cruz</a> said after the elections that Republicans "If Republicans do not do better in the Hispanic community ... in a few short years Republicans will no longer be the majority in our state." But it's not clear whether Cruz is the man to lead the party there. <a href="http://trailblazersblog.dallasnews.com/2012/11/will-identity-politics-work-for-the-gop-wooing-hispanics-in-texas.html/">He only won 35 percent of the Latino vote</a> in Texas, according to a Latino Decisions survey. His vocal opposition to the DREAM Act, deferred action and immigration reform that includes a path to citizenship are precisely the kinds of policy the GOP is looking to back away from in order to woo Latino voters.
After election night, former Mississippi Gov. <a href="http://www.politico.com/news/stories/1112/83562.html?hp=l7">Haley Barbour urged his fellow conservatives</a> to change their tune on immigration reform, saying: "we need to have an immigration policy that is good economic policy, and then -- and then the politics will take care of itself." Barbour had favored Marco Rubio's outline for an alternative to the DREAM Act, even going a step farther, saying he supported a path to citizenship.
Republican Iowa Congressman Steve King remains unconvinced that losing the Latino vote means the GOP should back down on its opposition to reform. After the election he fired off this tweet, which makes some kind of association between Santa Claus and a path to citizenship. King likes to compare immigrants to dogs, which he thinks is a <a href="http://www.huffingtonpost.com/2012/10/21/steve-king-immigrants-dogs_n_1998007.html?1350852519">compliment</a>.
Arizona Gov. Jan Brewer, who appears to be planning a 2014 reelection run, said in a televised interview that she's "fine and dandy" with immigration reform so long as the federal government secures the border first. It's not clear what her standard for securing the border is, or whether the governor who signed SB 1070 would support a path to citizenship.
On election night, the conservative Fox News host offered up the analysis on prime time television that "the white establishment is now the minority" and that people of color, and women, want "stuff" and "things." Insulting Latinos as freeloaders probably isn't going to warm them up to conservatism. Incidentally, it's also incorrect. Non-white voters only make up 28 percent of the electorate, <a href="http://www.pewhispanic.org/files/2012/11/2012_Latino_vote_exit_poll_analysis_final_11-09.pdf">according to Pew Hispanic Center</a>. Notwithstanding his election night comments, <a href="http://www.huffingtonpost.com/2012/06/19/bill-oreilly-jose-antonio-vargas_n_1610047.html">O'Reilly broke new ground with Jose Antonio Vargas</a> in June, when the conservative Fox News host said he favored offering a path to citizenship for immigrants brought to the country illegally as children.