01/18/2013 06:24 pm ET Updated Mar 20, 2013

Otter Health Care Reform Agenda Embraces Key Obamacare Provision

Now, it's a Republican's turn to defend President Barack Obama's health care reform law.

Idaho Gov. C.L. "Butch" Otter (R) published a document on his website entitled "Health Insurance Exchange Myths" Friday, in which he attempts to rebut critics of Obamacare and his own recent decision that the state would establish its own marketplace for health insurance under the law's rules.

Otter is one of just four Republican governors who made that call on a health insurance exchange. When he laid out his plan last month, Otter restated his opposition to the health care reform law but said Idaho would be better off shaping the law as much as it could. This is what Congress had in mind when it made state-run health insurance exchanges the first option under the law. Only 17 states and the District of Columbia agreed while 25 states will let the federal government run the exchanges for their residents instead.

states obamacare

Source: Henry J. Kaiser Family Foundation

Any Republican doing anything less than declaring Obamacare will be the end of the American experiment is naturally going to be on the defensive. And so Otter's office distributed its myths vs. facts document.

Befitting Otter's point of view, the "myths" and "facts" contain a heady mix of reasons why Idaho should cooperate with Obamacare and reasons why Obamacare is a bad idea. It could also be seen as a roadmap for conservatives seeking a rationale for not obstructing health care reform.

Here's a good one:

Myth - The Governor's decision to support a state-run health insurance exchange shows his support of Obamacare.

Fact - The Governor's intention, by supporting a state-run exchange, is to assert our independence and our commitment to self-determination, while fulfilling our responsibility to the rule of law.

And another:

Myth - Rejecting a state-run health insurance exchange will ensure Idaho will not be part of any exchange.

Fact - The Patient Protection and Affordable Care Act (PPACA) requires every state to have a health insurance exchange. The question is not whether Idaho will have an exchange, but rather who will build and administer the system - the federal government or the state. Ignoring the law would invite increased federal involvement in our state affairs through regulation of our insurance markets, forfeiting the creation of jobs in Idaho to other states, adding to the enlargement of the federal bureaucracy and incurring federal fees for operating costs associated with running a federal exchange, such as the current proposal to charge insurance companies a 3.5-percent fee for each policy premium.

The whole thing is worth looking over. (Idaho's Coeur d' Alene Press had it first.)

Expect to see more of this stuf from Republican governors who have broken from the pack and embraced, however reluctantly, parts of Obamacare, like Nevada's Brian Sandoval and New Mexico's Susana Martinez. Even some Republicans steadfastly opposed to the health care reform law quietly are taking steps to ensure it runs smoothly in their states, such as Virginia Gov. Bob McDonnell's administration.

Arizona Gov. Jan Brewer (R) is trying to sell Obamacare's Medicaid expansion in to her state, for instance. The conservative governor told legislators that she backed the Medicaid expansion Monday and staged a press event two days later at a Phoenix hospital flanked by health care and business leaders.

Unlike Sandoval and Martinez, who support a state-run health insurance exchange and the Medicaid expansion, Otter and Brewer are going only halfway. Otter's not broadening Medicaid and Brewer's not doing an exchange.


Health Insurance Exchange Myths by