States will take center stage for the second act of the nation’s overhaul of its healthcare system – and many of them already are fighting to get the first act repealed.
The governors in Michigan and Washington state have already set up panels to oversee the changes. But many states are fighting the overhaul. The attorneys general in 19 states are challenging the new law’s constitutionality, asserting that the federal government should not be allowed to force individuals to purchase health insurance because it exceeds Congress’ authority and violates Americans’ constitutional rights. And some governors have complained that, despite the additional federal funding they’ll get to provide health care to poorer residents, the law will still strain their already tight budgets.
States will oversee the expansion of Medicaid, enforce the new insurance reforms and set up and run the new insurance exchanges for small businesses, and people who aren't offered coverage through an employer. States can start applying for grants for consumer assistance offices and have until the end of the month to tell the federal government whether they want to participate in the high-risk pools that will be created this year to temporarily help people with pre-existing conditions get coverage.
States can even decide they don’t want to run the new exchanges and let the federal government do it. They need to make that decision by 2013, a year ahead of the start of the exchanges.
Health and Human Services Secretary Kathleen Sebelius, a former Kansas insurance commissioner and governor, acknowledges that states will face new costs. “But I would argue that those costs are far balanced by new benefits to states,” she said recently. Those benefits include having to spend less on uncompensated care, savings from reduced insurance paperwork, more federal funds to provide health care to children and more money to crack down on fraud and abuse.
States Have Big Say in How Much Health Reform Residents Will See (Greenville SC Online 4/15/10)
April 20, 2010