Course of state implementation efforts unchanged by high court's review

Politico reports that state plans appear unchanged by this week's events. Those that were moving ahead at full speed will likely continue to do so. Those who were taking a go-slow approach have no need to change strategies now. But for Massachusetts, the justices' questions regarding the individual mandate have triggered concerns that the challenges to the federal law could spur similar efforts at the state level.

Politico: States Stick To Their Plans Despite SCOTUS
The red states that have been moving ahead -; reluctantly -; to build the new health insurance exchanges are still working on them. The red states that were holding off, waiting on a Supreme Court decision, are still doing that. And so far, the blue states don't seem to have any second thoughts about moving full speed ahead. To be sure, oral arguments aren't always a reliable predictor of how the court will eventually decide. But supporters of the law have been taken aback by some of the aggressive questioning from the court's conservative justices this week (Millman, 3/29).

CQ HealthBeat: Expert: Exchanges Could Survive Without Mandate, But Rates Would Rise
If the U.S. Supreme Court rules that the individual mandate is unconstitutional but otherwise upholds the health care law, will state insurance exchanges survive? Yes, says one of the nation's leading experts on exchanges. But he thinks premiums charged on the exchanges will be higher than if the mandate were in effect (Reichard, 3/29).

Boston Globe: Ruling May Spur Foes To Mass. Health Law
A Supreme Court ruling against President Obama's landmark health care law could prompt challenges to the Massachusetts law that inspired it, according to legal experts and activists following the case. The tenor and aggressiveness of the justices' questions during three days of oral arguments on the federal law have caused some legal experts to predict the nation's highest court could strike down the individual mandate - if not the entire law. If that happens, observers say, the ruling would likely encourage a lawsuit in Massachusetts court, or embolden organizers of a ballot initiative to repeal the state's individual mandate (Borchers, 3/30).

California Healthline: Experts: Medicaid Expansion Will Stand; Mandate's Fate Unclear
Although they were divided in their predictions about specific challenges to the law, all of the experts agreed that substantive changes to the law could have profound impacts on plans to reform California's health care system. ... Francisco Silva, general counsel for the California Medical Association, said California has a lot riding on the Supreme Court's rulings expected in June. "We're so far ahead of most states in setting up our exchange, for California to all of a sudden have to switch gears and shift course would be difficult," Silva said (Lauer, 3/29).

Governors also begin taking positions and developing their own contingency plans -

The Connecticut Mirror: If Supreme Court Tosses Mandate, Malloy May Pick It Up
Jeannette DeJesús, the governor's special adviser on health reform, said Thursday that Connecticut may implement its own requirement that residents buy health insurance. ... Connecticut is ahead of many states in implementing the Affordable Care Act, moving forward quickly on a requirement for a health insurance exchange that would help people buy affordable policies. The state is also counting on millions of dollars the act will provide the state to expand coverage to the uninsured (Radelat, 3/29). 

The Sacramento Bee: California Gov. Brown Wants Health Care Changes Regardless Of Supreme Court Decision
Gov. Jerry Brown's administration vowed Thursday to continue pushing forward elements of the federal health care overhaul in California, even if the U.S. Supreme Court strikes it down. If the court does rule the federal law unconstitutional, state Health and Human Services Secretary Diana Dooley said California should at least consider enacting its own universal health care legislation, including requiring every Californian to buy insurance (Siders and Yamamura, 3/30).

The Baltimore Sun: O'Malley Still Thinks Health Care Will Be Upheld
While this week's Supreme Court hearings left many Democrats apprehensive that the justices will overturn President Obama's landmark health care law, Gov. Martin O'Malley remains an optimist. The governor said that after reading over transcripts of the hearings, at which Republican-appointed justices expressed deep skepticism about the constitutionality of the law, he's not at all sure that they're poised to strike it down in whole or in part (Dresser, 3/29).

The Atlanta Journal-Constitution: Healthcare Decision Has High Stakes For 2 Million Uninsured Georgians
The Supreme Court hearings this week on the federal law requiring citizens to buy health insurance have widespread implications in Georgia -- where about 2 million residents have no health insurance. The mandate calls for almost everyone to obtain insurance or face a penalty. But studies of the law's potential impact in Georgia predict that about 800,000 Georgians may remain uninsured even if the law is implemented (Teegardin, 3/29). 

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This article was reprinted from kaiserhealthnews.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.