Americans for Prosperity, which is trying to fight off exchanges in eight states. These efforts are mostly kept in-house, without help from outside groups.
“We work with the policy shop in D.C. a lot to make sure we’re on top of the 644 pages” of final exchanges rules, said Teresa Oelke, director of AFP’s Arkansas chapter. “I think that is the largest point against the exchanges. We’re signing up for a program that we’ll have to pay for by January 2015, but the federal government has control of every single decision.”
The approach of these national organizations has reflected sophisticated lobbying know-how, suggested Alabama Republican state Rep. Greg Wren, who is co-chairman of the National Conference of State Legislatures Federal Health Reform Implementation task force. Though an ALEC member, Wren is one of the main Republican voices arguing that lawmakers who opt for doing nothing and open the door to a federal exchange are putting their state sovereignty at risk.
“They’ve targeted … leadership, committee chairs, and oftentimes, people in those positions can stop or speed-bump any kind of legislation,” Wren said.