Byron York

Herbert is pleased, but a little baffled at why getting an ordinary waiver was so hard. "I appreciate the fact that they've come around after eight months, but does it take a governor having to talk to the president of the United States to make a simple cost-saving change?" he asks. "And the bigger question is why in heaven's name do states have to ask for permission anyway?"

Herbert and other governors fear bigger problems ahead. New mandates in the Affordable Care Act, also known as Obamacare, will cost Utah $1.2 billion over the next decade, an increase Herbert calls unsustainable.

He's still frustrated that Congress and the Obama administration didn't pay much attention to governors during the Obamacare debate. "We were never even invited to the table," he says. And he's not impressed by the president's promise to allow states to opt out of Obamacare, as long as they meet the administration's requirements for coverage. "He's saying, you can have flexibility, as long as you do it our way," says Herbert.

But Herbert is happy the new Republican leadership of the House is paying more attention to the states. During his visit to Washington, Herbert, along with Mississippi Gov. Haley Barbour and Massachusetts Gov. Deval Patrick, testified before the House Energy and Commerce Committee, urging that Congress allow the states more leeway in paying for health care. "Real healthcare reform will arise from the states, not be imposed by the federal government," Herbert told the committee.

That seems unlikely, as long as it takes presidential intervention for the smallest improvements in the system. But Herbert is still hoping for the best.

Byron York

Byron York, chief political correspondent for The Washington Examiner