Health care splinters GOP in Washington

OLYMPIA – Federal health care reform may be among the most controversial issues in the nation. In many ways Washington state could be considered ground zero for that partisan debate.

Republicans in Congress have vowed to repeal it, with Eastern Washington’s Republican Rep. Cathy McMorris Rodgers sponsoring an amendment to keep any money from being used to implement the 2009 law. The state’s Democratic senators, Patty Murray and Maria Cantwell, are big supporters of the law and say it can help ease the state’s growing Medicaid costs.

Washington Attorney General Rob McKenna, a Republican, last year joined a lawsuit seeking to block the federal mandate to buy health insurance. Washington Gov. Chris Gregoire, a Democrat, joined the federal government to support the law, saying the state will be worse off without it.

So if the Legislature considers a proposal to change Washington’s health care laws to conform with the federal Affordable Care Act, the vote should split predictably down party lines, right?

That’s not what happened last week, though. The Senate voted 45-4 to revise state law to line up with new federal rules such as banning insurance companies from rejecting children and teens for pre-existing conditions, covering dependents on their parents’ insurance through age 26, and lifting lifetime benefit maximums. The bill has been sent to the House for consideration.

Although all no votes came from Republicans, the GOP leadership voted yes and the bill passed with almost no debate.

One of the four no votes, Sen. Mike Baumgartner of Spokane, said, “There’s no reason for the state to rush headlong into Obamacare. Why put the federal government in charge of one-sixth of the economy?”

Senate Minority Leader Mike Hewitt of Walla Walla, however, said, “I think there are many things about Obamacare that are palatable.” The Senate bill covered some of those things, like the pre-existing conditions regulation. What it didn’t cover likely was a big reason for the broad approval – an individual mandate to buy health insurance or pay a fine. That mandate doesn’t become law until 2014, so there was no need to make it part of this year’s proposed changes.

“There are differences of opinion among key elected officials in the state on the mandate,” Sen. Mark Schoesler, R-Ritzville, said in measured understatement.

The mandate is what McKenna cited when he joined the federal lawsuit in Florida that eventually totaled 26 states’ attorneys general or governors. While many aspects of the Affordable Care Act may be good policy, the federal government has no constitutional authority to require its citizens to buy health insurance, he said.

Although he believes the federal courts should reject the mandate and keep other parts of the law, that’s not what happened. U.S. District Judge Roger Vinson in Florida ruled that the whole law is unconstitutional.

Any implementation of the law should be halted, Vinson ruled in January.

Democrats quickly criticized McKenna for getting more than he said he bargained for.

Gregoire filed a motion asking Vinson to recognize that while McKenna is challenging the new health care law, other Washington officials defend it.

Washington’s dichotomy was one reason Vinson listed for issuing a stay to his order this month.

“There is even disagreement within the plaintiff states,” he wrote. While McKenna was among the plaintiffs who asked that he stop the federal government from implementing the law, “the governor of Washington has just filed an amicus brief specifically opposing that request.”

Vinson acknowledged that other judges have reached other conclusions about the law – two have ruled it constitutional while a third has said the mandate is unconstitutional but the rest of the law is not – and said the whole issue is clearly something that has to be decided by the Supreme Court, the sooner the better.

Partisans on both sides found reason to declare victory in Vinson’s stay. Gregoire said it showed Vinson recognized that the new law benefits businesses, allows children to stay on their parents’ health care until 26 and prohibits people from being denied coverage for pre-existing conditions.

“The Affordable Care Act is the most important step in achieving affordability and access to health care,” she said.

McKenna accused Gregoire and other Democrats of “demagoguery.” In a guest column for the website Crosscut last week, he wrote that Congress knew a major change in the law would be challenged, yet it removed the severability clause that would have protected any provision not specifically thrown out by the courts.

While four courts have split on whether the law is constitutional, not one of them has called the challenges frivolous, “the charge that several state and federal elected officials and law school academics hastily and erroneously hurled at the states’ lawsuit,” McKenna wrote.