Alabama Gov. Robert Bentley (R) said Tuesday that he will reject two key provisions of President Barack Obama's health care reform law: one that would create a state health insurance exchange and another that would accept federal funds to expand Medicaid rolls for low-income residents.
"I will not set up a state exchange in Alabama," Bentley said during a speech to the Birmingham Business Alliance, according to the Birmingham News. He went on to call Obamacare "the worst piece of legislation passed in my lifetime," the Associated Press reports.
Governors recently received an extension to submit blueprints for statewide insurance exchanges, but have only until Friday to announce their intention to pursue or forgo the option altogether.
Bentley, a physician, created a commission last year to study creation of an exchange, but he was also one of 21 Republican governors who complained to the Obama administration that states needed more flexibility in deciding which companies participate and what benefits are covered.
The exchanges will give the uninsured a place to price insurance and apply for subsidies. Bentley said Tuesday operating an exchange could cost Alabama up to $50 million a year.
Bentley also stated that he would "not expand Medicaid as it exists under the current structure because it is broken."
HuffPost's Jeffrey Young reported earlier this week on some of the difficult considerations for the Republican governors who have attempted to maintain their opposition to the federal law, and in so doing, reject the federally subsidized Medicaid expansion:
Obama's law would offer coverage to anyone who earns up to 133 percent of the federal poverty level, which is $14,856 this year. If every state participated, 17 million uninsured people could gain health coverage, according to the Congressional Budget Office. Because the Supreme Court made this expansion optional when it upheld the law, 3 million fewer people will be covered by 2022, the budget office projects.
Health care providers in Florida and other states that threaten to reject the Medicaid expansion will also put pressure on state legislators and governors. Hospitals that treat large numbers of uninsured people, and eat the cost of their unpaid bills, stand to gain from more people having health coverage, especially since the new law scales back programs that currently provide funding to mitigate those costs.
Bentley joins other Republican governors, such as Florida's Rick Scott, in his decision not to implement the Obamacare measures. A recent report in the Miami Herald, however, suggested that Scott was under heavy pressure to reconsider his stance.