The official version is that it’s a budgetary issue – that seems unlikely. John Oxendine, Georgia’s insurance commissioner, a Republican, has his eye on the Governor’s mansion in the upcoming election. The rebellion is cleverly wrung; no patients will lose any benefits nor will it affect the cost of insurance for Georgians. What it does is make a statement; while putting the burden on the Federal government to oversee the distribution of funds to those in need within the state.

Further proof of the real cause of the insubordination is found in Oxendine’s letter to Kathleen Sebelius, U.S. Secretary of Health & Human Services. In that letter, he said that he would not involve Georgia in “a scheme which I believe the Supreme Court will hold to be unconstitutional, leads to the further expansion of the federal government, undermines the financial security of our nation, and potentially commits the State of Georgia to future financial obligations.” Obviously it wasn’t really about the state’s cost of administering the funds provided by the Federal government. Using the fate of uninsured high-risk citizens as a soapbox for a political statement is transparent. The Republican Primary for Governor is coming up in July. Oxendine hopes to distinguish himself from the field with this move, even though the action changes nothing – amounting to nothing more than token blustering.

Mr. Oxendine claims he is not alone in the tactic, saying that he has spoken to (at least) two governors and one insurance commissioner who have also been considering a refusal to institute their state high-risk pools. When asked, he declined to name those states. This is in keeping with the 19 state Attorney Generals who are filing lawsuits against the Federal government, challenging the Constitutionality of the new health care law. Oddly enough, Georgia’s state Attorney General does not agree.

The U.S. government stands firm in its resolve to help those who have pre-existing conditions. The new health care law provides for funds to reduce the costs of insurance premiums and for there to be high-risk pools initiated for those people. Nicholas Papas, spokesman for Kathleen Sebelius, said “For too long, Georgians with pre-existing conditions have been locked out of the insurance market. If state officials in Georgia elect not to participate in the high-risk pool program, our department will work to ensure Georgians with pre-existing conditions have access to affordable insurance through the federal high-risk pool program that we will establish this year.”

It seems entirely convenient for the states that are choosing to boycott the high-risk pool program. By doing so, they appease their Republican constituents. Yet they don’t attract meaningful wrath, because those constituents are still going to get the coverage through Federal administration. The ultimate irony may be that, given the opportunity to administer their own pools, these Republicans place it back in the hands of the Federal government. In doing so, they cause the Federally-run healthcare insurance plan that they objected to in the first place.