Welcome to Obamacare Nation

Share The Grio Share The Grio
Obamacare

Obamacare supporters react to the U.S. Supreme Court decision to uphold President Obama's health care law, on June 28, 2012 in Washington, DC. Today the high court upheld the whole healthcare law of the Obama Administration. (Photo by Mark Wilson/Getty Images)

After two years of intense effort to eliminate or least weaken President Obama‘s health care law, Republicans at least for now are accepting it’s here to stay, and the administration is making more explicit moves to codify “Obamacare.”

Immediately after the election, House Speaker John A. Boehner declared in an interview “Obamacare is the law of the land” and suggested his party was done holding votes to repeal the law in Congress. A group of 16 Republican governors have announced they are not creating “exchanges,” the state-based marketplaces to purchase insurance that the law requires.

This is an easy way for these Republicans to suggest to their party’s base they still oppose Obamacare, but the practical effect is that it gives the Obama administration more power, since the federal government will run the exchange in states where the governor refuses to set one up.

Florida Republican Gov. Rick Scott, initially one of the law’s biggest opponents, now says he is reconsidering the law’s provision to expand Medicaid.  More than 15 million people, including about a million in Florida alone, will be newly eligible for Medicaid under the law, but governors have the right to refuse federal funding that would pay for the Medicaid expansion.

Several Republican governors, including Scott, had previously indicated they will refuse the funding, arguing the Medicaid expansion will eventually cost their states too much money. (The law initially covers 100 percent of the Medicaid expansion, meaning it costs the states nothing, but it will eventually require states to put up about 10 percent, which will cost billions for large states like Florida.)

Scott’s shift in the stance could be followed by other GOP governors, who could face pressure from hospitals in their states to accept the funds, as hospitals are often forced to pay the costs of patients who come in but don’t have insurance.

To be sure, most of the law’s provisions, including the Medicaid expansion and the exchanges, don’t fully go into effect until 2014, so much time remains for Republicans to reignite their hostility to the health care law.

But the early indications are that Obama’s win in November has cemented the legitimacy of his health care law, even to Republicans who have long resisted it.

And the Obama administration is taking more steps to implement the law. This week, the Department of Health and Human Services released a series of rules that will mandate the law’s key provisions, specifically that health insurance companies can’t charge higher prices to people who already have illnesses or charge women higher rates than men.