States Divergent in Plans for Health Care Ruling
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.
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.
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."