Some states snub health reform; in others, election will decide fate of law's implementation

Politico reports that races at the state level could affect the health law more than congressional races. "Governors who oppose the legislation can refuse to set up pieces of the law, such as the state-based insurance exchanges where most Americans will purchase coverage beginning in 2014. In many cases, they also can appoint insurance commissioners and Medicaid directors with directives to refuse to participate in implementing the law or the federal funding associated with it." For example, Sen. Sam Brownback, who is running for governor in Kansas says he will fight reform "every step of the way."

"Republican Nikki Haley has promised not just to block the law if elected governor in South Carolina but to lead a group of governors in repealing it, according to local media reports. In Pennsylvania, Republican Attorney General Tom Corbett joined the multistate suit and is now running for governor" (Haberkorn, 10/12).

Politico reports in a separate story that "a handful of governors" are already "beginning to seriously flex their muscles in attempts to block the federal health reform law by rejecting grants or legislative action, a worrisome move for health reform's most stalwart supporters. … The vast majority of states have applied for initial rounds of grants, but several have remained notably obstinate. Alaska and Minnesota were the only states not to apply for health exchange planning grants. Three others — Wyoming, Iowa and Georgia — joined them in not pursuing an additional $1 million grant for rate reviews, released in the summer." Utah already operates its own health insurance exchange (Kliff, 10/12).

In Connecticut, gubernatorial candidates are sparring about the health law, The Associated Press reports. "Democratic gubernatorial nominee Dan Malloy has launched new salvos against Republican rival Tom Foley, saying Foley's health care plan would allow insurance companies to deny coverage based on pre-existing conditions and avoid mandated coverage for cancer screenings. … Foley's health care plan says he wants to allow small companies that haven't previously provided health insurance, and any company whose health insurance costs exceed a certain percentage of its payroll, to offer health plans focused on basic care needs and be exempt from certain state mandates. ... But Foley's plan doesn't specify the mandates from which companies would be exempt" (Collins, 10/11).