We're hearing a lot of tough talk from Republicans as we did from LA Gov. Bobby Jindal on this Sunday's Meet the Press about how they're not going to cooperate at all in enacting provisions in the Affordable Care Act now that the Supreme Court has
July 1, 2012

We're hearing a lot of tough talk from Republicans as we did from LA Gov. Bobby Jindal on this Sunday's Meet the Press about how they're not going to cooperate at all in enacting provisions in the Affordable Care Act now that the Supreme Court has ruled on its Constitutionality.

Howard Dean did a nice job of pointing out that states are going to get the insurance exchanges whether they're willing to cooperate or not because the federal government will set them up if governors like Jindal refuse to, as he was promising here. He also explained how it didn't make any sense economically for them to refuse the money in the Medicaid expansion.

Once you have hospitals and businesses and voters getting upset with the politicians for saying they're going to refuse that money and they start hearing from them after a lot of this national dust up is over, we'll see what Jindal actually does. This is the same guy who was calling the stimulus plan a failure and then did this: Jindal takes credit for stimulus, presents constituents with jumbo-sized stimulus check.

Transcript below the fold.

DAVID GREGORY: So much to get to here. And I want to start with you, Governor Jindal. You heard me ask Leader Pelosi, "Is the fight over?" She said, "Yes." Republican attempts to repeal it are basically fantasy at this point. But you and other Republican governors say no. You're not going to fully implement the law, even though the Supreme Court has spoken. Why not?

GOV. BOBBY JINDAL: Absolutely. Look, this election, this coming election, gives American voters a chance. We've got two very different candidates. President Obama's doubled down on this-- the creation of a brand new entitlement program, over $500 billion in Medicare cuts, $500 billion in tax increases, $1.7 trillion in new spending we can't afford.

We can't afford the programs we have today and he wants to create a new program. There's never been one day a majority of the American people have wanted this. He forced this through on a party line vote without one Republican vote in support. So I think the voters have--

DAVID GREGORY: Wait, governor, that's (UNINTEL) what are you not going to do? You're--


DAVID GREGORY: --really going to not cover people who need insurance in your state even after the federal government passed this, the Congress passed it and the Supreme Court said it's constitutional?

GOV. BOBBY JINDAL: David, every governor's got two critical decisions to make. One is do we set up these exchanges. And, secondly, do we expand Medicaid. And no, in Louisiana, we're not doing either one of those things. I don't think it makes sense to do those. I think it makes more sense to do everything we can to elect Mitt Romney to repeal Obamacare.

Think about adding a 16, 17 million Americans into an unreformed Medicaid program. This is simply growing government healthcare. You listen to the government's own experts. They've said healthcare spending's going up. The president promised us premiums would go down $2,500. CMAS actually say that healthcare spending will go up 7% in 2014 as this law begins to be enacted.

The reality is they did not bend the cost curve down as the president's promised. They did not make healthcare spending more sustainable. We can't afford another entitlement program. We're going to have more people in the cart rather than pulling the cart. We're going to go the way of Europe--


GOV. BOBBY JINDAL: --if we don't repeal this law.

DAVID GREGORY: There are a lot of facts and figures there, a lot of charges which are disputed, so I want to try to flow this down and break it down so it's understandable. Governer Dean, on what Governor Jindal is proposing to not do, can you actually explain what the impact of that will be?


DAVID GREGORY: And how audacious you think that will--

GOV. HOWARD DEAN: Let's deal with the exchanges. First, if you don't put in your own exchange the federal government's going to run one for you.

DAVID GREGORY: The exchange is where you would actually go and buy--

DAVID GREGORY: --a program.

GOV. HOWARD DEAN: To buy health insurance. So he has a choice. Bobby has a choice, basically, of having this done for him by the federal government or doing it himself. So I think that's a no brainer. But, look, in my state we have had universal healthcare for every kid under 18 for 20 years by an expansion of Medicaid.

In Louisiana, it's 48th in the country in terms of child poverty, 48th in the country in terms of premature death, 48th in the country in terms of industrial accidents and so forth. Just by expanding Medicaid alone, by accepting the president's Medicaid expansion, 340,000 out of those 860,000 uninsured people get covered. This is a great deal.

DAVID GREGORY: And the federal government pays for it--

GOV. HOWARD DEAN: And it pays for--

DAVID GREGORY: --for three years.

GOV. HOWARD DEAN: --100% of it. Now I have some sympathy with the notion that Bobby raises that we don't want to get into this thing and soon they're going to cut it back to 90% and 70%. But right now, for the next 10 years, this program is pretty much fully funded. And I'll just leave this, so we're dealing with a lot of facts and figures here.

When I was running for president and campaigning in South Carolina we calculated that if the South Carolina governor at that time had done what we did in Vermont in terms of matching money for Medicaid, 20% they put up, 80% the feds put up, they would have raised their entire gross state product by 2% simply by having the same Medicaid rules that we do.

So I think this stuff about not accepting Medicaid and not accepting exchanges is crazy. If you don't like the law, I understand. I don't like the law all that much. But the fact of the matter is it is the law, it will work, it's necessary and Governor Romney knows it because he did it in Massachusetts.

GOV. BOBBY JINDAL: A few things real quickly. On Medicaid expansion I think this is a great philosophical difference again being Republicans and Democrats, with Mitt Romney and President Obama. You just heard Howard say that growing Medicaid grows your state's economy.

Look, federal dollars aren't free. Those dollars are coming from us, from our children, our grandchildren. We're borrowing money from China to spend on government programs we can't afford. The best thing we can do is help people get good paying jobs instead of making them more dependent on government programs.

Every month since I've been governor our unemployment rate's been below the national and southern averages. Under President Obama median family income's gone down $4,000. Since I've been governor our per capita income's gone up over $2,000. The best way to help people get better healthcare is to get them better paying jobs so they can afford healthcare. Now, look, I do agree we need to reform the health insurance marketplace. I do agree the status quo's not acceptable. I just don't think this expensive, unsustainable entitlement program--


GOV. BOBBY JINDAL: --is the solution to our problems.

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