Salon’s Irin Carmon complained sadly this week that “the federal exchanges [are] being burdened by so many more people than expected because for political reasons, a lot of governors refused to set up their own exchanges.” This line is not just askew, it is deeply presumptuous. While the idea that the system is failing because of excess demand has been widely debunked, Carmon is correct to note that a majority of governors declined to set up exchanges, and that they did so for “political reasons.” But, one might ask, “So what?” Texas is a state in a federal nation, and the law that the president signed allows the states to decide how to respond to what is, ultimately, a federal initiative.
To believe that the states have in some way “nullified” or “sabotaged” the law by choosing not to do the lifting themselves is to believe that the states are merely regional departments of the federal government and that their electing whether or not to expand Medicaid or set up health-care exchanges is illegitimate. In this case, “political reasons” means doing what the people in their states wanted them to do. What next? That “if Americans had just chosen to sign up, then the system would have worked”?
A frequent criticism of this president is that he does not yet appear to have noticed that he heads up the government. Barack Obama is quite capable of saying that he is as “angry as anyone” about the mistakes of his own administration, but a little less adept at knowing when to say “sorry.” Even here, with the law that bears his name, and which he fought for years to pass and to protect, his instinct is to look elsewhere.
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