— BIRMINGHAM, Ala. (AP) — Alabama's governor said Tuesday the state won't create a health insurance exchange under the federal Affordable Care Act or use the law to expand Medicaid to cover more low-income Alabamians.
Republican Gov. Robert Bentley told the Birmingham Business Alliance that he expects at least half of the states to make the same decision in an effort to force Congress to make changes in what he called "the worst piece of legislation passed in my lifetime."
Friday is the deadline for states to notify President Barack Obama's administration whether they will create a state exchange or let the federal government implement one for them.
Bentley, a physician, created a commission last year to study creation of an exchange, but he was also one of 21 Republican governors who complained to the Obama administration that states needed more flexibility in deciding which companies participate and what benefits are covered.
The exchanges will give the uninsured a place to price insurance and apply for subsidies. Bentley said Tuesday operating an exchange could cost Alabama up to $50 million a year.
Bentley joins the Republican governors of Louisiana, Florida and South Carolina in declining to create exchanges under the federal law's guidelines.