Two Months Ago, GOP Governors Asked the President for Health Reform Flexibility. Didn't They Mean It?

Less than two months ago, the Republican Governors Association lectured President Obama on state flexibility for pursuing health reform: "The one-size-fits-all approach to healthcare adopted last year does not work in the states and imposes unnecessary financial burdens on already strapped state budgets."

Such a comment ignored the high degree of state flexibility already in the new health reform law, which allows states to receiver waivers from federal rules if they have alternate approaches for expanding coverage and cutting costs as much as the federal law would.

But the current law wouldn't grant those waivers until 2017, meaning that the states would have to try out the federal approach for three years first.

Yesterday, the President embraced the Wyden-Brown bill, which would allow states to get waivers in 2014, right when the federal law is set to be fully implemented. In other words, states wouldn't have to wait.

Those state-rights lovin' conservatives must be celebrating, right?

Apparently not.

The head of the RGA, Texas Gov. Rick Perry said, "I have great concern that the administration is not going to go forward with the flexibility that we're asking for ... governors just want freedom to manage their states as they and their citizens see fit."

I don't think Gov. Perry understands what "flexibility" means.

If the Wyden-Brown bill passed, he would have the freedom to pursue the twin health care goals of expanded coverage and cost control however he and his citizens saw fit. Wouldn't even need to have an individual mandate requiring most people to purchase health insurance.

If conservatives had a more private market-oriented approach to expanding coverage and cutting costs -- more market-oriented than the current law's plan for 50 state-regulated health insurance marketplaces consisting of only private insurers -- here is their golden opportunity to prove it.

Of course, it's also a great opportunity for liberals to show that having a public insurance option or a state-based single-payer system with no private insurance, as Vermont is eager to pursue, can also expand coverage and cut costs.

That would not be a completely true statement, if conservatives actually had their own private market solutions for expanding coverage and cutting costs. Then the President's plan would effectively provide flexibility for both conservative and liberal ideas.

(Conservatives like those at the Heritage foundation used to have ideas like that, such as the "individual mandate." It just stopped being accepted by conservatives once it was accepted by President Obama.)

But I can only conclude from the conservative reaction that what today's conservative leaders mean by "flexibility" is not flexibility regarding how to pursue the widely popular goals of expanding coverage and reducing costs. Instead, conservatives seem to mean they want the flexibility to not have to care at all about expanding coverage to the 50 million Americans who are uninsured.

If conservatives wish to prove me wrong, then they should embrace Wyden-Brown, join hands with President Obama, and get to work on their own health reform ideas.

If conservatives want to prove that they don't really believe in any sort of health reform that expands coverage and cuts costs, then they should just keep doing what they're doing.

Originally posted at