States divergent in plans for health care ruling

Jun 28, 2012, 11:36 AM

Associated Press

CHICAGO (AP) – As the nation awaits the Supreme Court ruling on President Barack Obama’s health care overhaul, states across the country are considering how they will respond to the historic decision. Some Democratic-led states vow to push ahead with various provisions no matter what happens. In some Republican territories, elected officials insist they will try to hold off on implementing the law, even if the court upholds it. And most states are bound to miss key deadlines if the law or even pieces of it survive.

___

PUSHING AHEAD:

One contingent of states plans to stay the course regardless of the high court ruling.

Oregon’s Legislature voted in 2009, a year before Obama’s overhaul was approved, to create an online state health insurance exchange. If the court strikes down only the federal requirement that almost everyone obtain health insurance, the state’s exchange director Rocky King says he still can build a profitable exchange to launch in 2014.

“We assume we can go forward,” King said. “It may make a difference in terms of the number of people we can enroll, but we think the exchange has value with or without the mandate.”

If the court strikes down the entire health care law, however, the exchange would lose more than $60 million in federal grants and thousands of potential customers. In that scenario, state officials would have to wait for cues from the Obama administration and for Congress to decide a path forward, King said.

California has been a model for the federal health care overhaul since the law’s passage and has begun implementing parts of it already, including the beginnings of health care exchanges. The state also has banned insurers from refusing coverage for children with pre-existing illnesses and allowed young adults to stay on their parents’ plans through age 26.

California passed its own state legislation to ensure those measures are preserved even if the federal law is thrown out. But that doesn’t mean the state is unaffected by Thursday’s ruling. As one of the law’s biggest financial beneficiaries, it stands to gain as much as $15 billion annually in federal money for health programs.

Hawaii also has been moving full speed ahead and joined several states last year in filing a friend-of-the-court brief in support of the new law.

“Our goal is universal health coverage here,” said Beth Giesting, who was hired as a coordinator to implement the overhaul’s changes in Hawaii.

In Massachusetts, which laid the groundwork for the federal health care law with a sweeping 2006 state program, officials say they will continue efforts to expand coverage to nearly all residents no matter what. But like California, the state could lose hundreds of millions in assistance if the federal law is knocked down.

“Even in a worst-case scenario of the health care law being struck down entirely, Massachusetts is going to forge ahead,” said Glen Shor, executive director of the Commonwealth Health Insurance Connector Authority.

___

DIGGING IN:

On the other side are Republican leaders who vow that no matter how the Supreme Court rules, they will not act on the overhaul before November, when they hope the GOP can win back the White House and the Senate and repeal the law.

Republican Wisconsin Gov. Scott Walker said this week that only in the event of a GOP defeat would Wisconsin “figure out some alternative within the state.”

Robert Kraig, executive director of Citizen Action of Wisconsin, a health care advocacy group that supports the law and expanding health insurance coverage, said the governor is “on the far end of the spectrum in terms of trying to block the law and doing nothing to prepare for it.”

But Walker is not alone.

Lawmakers in Idaho, where about 19 percent of residents are uninsured, were the first in the nation to pass a law in 2010 requiring the state to sue the federal government over the overhaul. Last year, they toyed with the idea of nullifying the health care law and have taken no steps toward implementation since. Now they’re banking on the Supreme Court turning down the measure or a future repeal.

South Dakota Gov. Dennis Daugaard, Florida Gov. Rick Scott and South Carolina Gov. Nikki Haley have said they too will wait until November to before acting on any surviving parts of the law.

___

MOVING MONEY:

Millions of people already have received new benefits under the law. But those could disappear it is struck down, and many states are trying to figure out what to do if that happens.

Minnesota Gov. Mark Dayton, a big supporter of the federal overhaul, extended Medicaid coverage last year to 84,000 vulnerable adults. But Dayton has said little publicly about the implications of the Supreme Court’s ruling for Minnesota. That leaves many unanswered questions about the fate of the people Dayton switched to the joint federal-state Medicaid program from less generous state-funded programs.

A ruling against the law also would threaten other planned expansions, such as in Washington state, which received $128 million to help set up its insurance exchange and an additional $200 million for its preexisting-condition insurance pool. Officials are uncertain whether that money could stay with the state or would have to be returned.

In Michigan, the law has brought widespread benefits: More than half a million seniors have received some free preventive health care services this year. And 1.8 million residents now receive preventative services with no co-pay. Another 57,000 young adults in Michigan are on their parents’ health insurance plans.

Last week, U.S. Health and Human Services director Kathleen Sebelius visited Detroit to announce grants for six Michigan health centers to help expand access to care under the law. Officials there aren’t sure what they’ll do if that money disappears.

Funding for North Dakota’s 15 community health centers may be jeopardized, and three other planned centers might not be built if the federal law is overturned.

___

SWEATING DEADLINES:

Most states have taken few _ if any _ steps toward creating the insurance exchanges that are a cornerstone of the health law. The online marketplaces would allow people and small businesses to comparison-shop for health insurance.

So if the court upholds the mandate to establish exchanges, many states will have to scramble to get their plans approved by January and the programs running a year later. As of March, only 13 states and Washington, D.C., had adopted plans for exchanges.

In Obama’s home state of Illinois, Democratic Gov. Pat Quinn considered an executive order to establish an exchange, but state Rep. Frank Mautino said it’s too late. The first year of the project will have to be a joint state-federal exchange, he said.

In Michigan, House Republicans have refused to let state officials start setting up the MI Health Marketplace before the Supreme Court ruling. Gov. Rick Snyder is one the few Republican leaders who has acknowledged considering a state-federal partnership to get an exchange in place.

“I’m just trying to be a pragmatist here,” Snyder said Tuesday.

In Indiana, Republican Gov. Mitch Daniels ordered state agencies to investigate the cost and feasibility of an online health insurance marketplace in January 2011, but Daniels told the agencies to keep their work in the planning stages until the court ruled.

___

Associated Press writers Carla K. Johnson in Chicago; Scott Bauer in Madison, Wis.; John Miller in Boise, Ida.; Kathy Barks Hoffman in Lansing, Mich.; Tom LoBianco in Indianapolis; Shaya Mohajer in Los Angeles; Jonathan Cooper in Salem, Ore.; Oskar Garcia in Honolulu; Steve LeBlanc in Boston; Rachel La Corte in Olympia, Wash.; Martiga Lohn in St. Paul, Minn.; James MacPherson in Bismarck, N.D.; Chet Brokaw in Pierre, S.D.; Bill Kaczor in Tallahassee, Fla.; and Meg Kinnard in Columbia, S.C. contributed to this report.

(Copyright 2012 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.)

United States News

Demonstrators block traffic protesting the death of Tyre Nichols on January 27, 2023 in Memphis, Te...
Associated Press

Memphis police chief disbands unit responsible in beating of Tyre Nichols

The unit is composed of three teams of about 30 officers and had been inactive since Tyre Nichols' Jan. 7 arrest.
2 days ago
The image from video released on Jan. 27, 2023, by the City of Memphis, shows Tyre Nichols on the g...
Associated Press

Memphis authorities release video in Tyre Nichols’ death

Video showing Memphis officers beating a Black man was made public Friday after they were charged with murder in the death of Tyre Nichols.
3 days ago
Demonstrators stage a rally in front of the White House to celebrate President Joe Biden's plan to ...
Kevin Stone

Lawsuits keeping over 300,000 Arizonans from getting student loan relief

Lawsuits are preventing more than 300,000 Arizonans from having some or all of their student debt dismissed, the Biden administration said Friday.
3 days ago
FILE -  A Goodyear tire sits on display at a tire shop on Feb. 12, 2014, in South Euclid, Ohio. A f...
Associated Press

Arizona lawyer subpoenaed in criminal investigation of Goodyear tires

A federal grand jury in Los Angeles is gathering evidence in a criminal investigation of Goodyear recreational vehicle tires.
4 days ago
Following days of rain, floodwaters cover streets in the Planada community of Merced County, Calif....
Associated Press

Atmospheric rivers in California boost water allocation for cities

Public water agencies in California will be getting more water from the state because of recent heavy rain.
4 days ago
(Brian Munoz/St. Louis Post-Dispatch via AP, File)...
Associated Press

FDA declines to regulate CBD; calls on Congress for fix

The Food and Drug Administration said Thursday there are too many unknowns about CBD products to regulate them as foods or supplements under the agency’s current structure and called on Congress to create new rules for the massive and growing market. The marijuana-derived products have become increasingly popular in lotions, tinctures and foods, while their […]
4 days ago

Sponsored Articles

...
Quantum Fiber

How high-speed fiber internet edges out cable for everyday use

In a world where technology drives so much of our daily lives, a lack of high-speed internet can be a major issue.
...
Day & Night Air Conditioning, Heating and Plumbing

Prep the plumbing in your home just in time for the holidays

With the holidays approaching, it's important to know when your home is in need of heating and plumbing updates before more guests start to come around.
...
Quantum Fiber

How high-speed fiber internet can improve everyday life

Quantum Fiber supplies unlimited data with speeds up to 940 mbps, enough to share 4K videos with coworkers 20 times faster than a cable.
States divergent in plans for health care ruling