If she could, Gov. Nikki Haley would do away with the Patient Protection and Affordable Care Act (Obamacare) altogether.
But the re-election of President Barack Obama and the continued Democratic control of the U.S. Senate says that wish will likely be unfulfilled, at least in the near term.
Nevertheless, the governor is rejecting what she can, when she can.
And she makes some strong arguments against that sweeping federal law.
In July, she said “no” to the expansion of Medicaid in South Carolina. Most recently, she said the state will not set up a health insurance exchange.
The Medicaid expansion would have added 500,000 South Carolinians to the 800,000 already served by Medicaid. She said the state would not participate because, even though the federal government would pay for the expansion at first, eventually the states will be responsible for paying up to 10 percent of the costs.
Mrs. Haley makes a fair case that it would be irresponsible to obligate South Carolina to pick up the tab when it is not clear the money will be available. Would that more elected officials kept the bottom line in mind.
Besides, she thinks there are better ways to address health needs than pouring money into “a broken system.” For example, she would rather see states receive federal block grants for Medicaid expenses.
And she espouses searching for ways to save money. She is hopeful that efforts will be successful to reduce the number of elective births before the 39th week of pregnancy. All hospitals in the state agreed to try to reduce the number of such births, which cost about $5,500 more than full-term deliveries.
This month, she joined 14 other states that will not establish health insurance exchanges, a provision of Obamacare that is supposed to help consumers make the best insurance choices for themselves. So far, 22 states have elected to establish exchanges on their own.
Clearly, the country remains divided over the health care law, which many projections show will impose huge costs.
Gov. Haley’s latest stand could be seen as mostly symbolic in that South Carolinians will be served by a health insurance exchange regardless of the state opting out.
Instead of being South Carolina-run, it will be run by the federal government.
But Mrs. Haley says the federal government is going to have control anyway, and the state can avoid the bureaucratic headaches of implementing its own.
Realistically, any benefit would likely be diminished if the exchange were in the hands of a hostile management.
With the president’s re-election, it appears Obamacare is not going away — even more reason for Gov. Haley to continue her vigilance in identifying ways the state can avoid pitfalls the law is likely to bring.