State officials pursue divergent paths on health law

Missouri Republicans aim to bar the Democratic governor, or the federal goverment, from setting up an insurance exchange without approval of voters or state legislators, while in Massachusetts, which implemented the prototype of the federal law, 44,000 residents pay fines for not carrying insurance.

St. Louis Beacon: Kinder, Lager Disagree On How To Block Implementation Of Insurance Exchange In Missouri
Missouri Lt. Gov. Peter Kinder says he plans to raise private money -- and won't use any public funds -- to pay the legal expenses for his planned lawsuit challenging the ballot wording for a measure on a proposed state insurance exchange. The measure would not allow the creation of a health-insurance exchange in Missouri unless it had been approved by the General Assembly or by voters. It aims to bar Gov. Jay Nixon's administration, or the federal government, from setting up an exchange without approval of voters or legislators (Mannies, 7/5).

CT Mirror: Impact Of Health Care Act On Connecticut Residents Will Vary Widely
The Supreme Court's decision last week to uphold most of the Affordable Care Act has renewed political debate over the health care overhaul. But its full impact may not be felt for years. While some reforms have already been enacted, the very heart of the Affordable Care Act won't be implemented until 2014, with the debut of state insurance exchanges that aim to give individuals and companies more -- and better -- coverage choices. … Here is how it is already affecting -- or likely to affect -- some Connecticut residents (Radelat/Masroor, 7/5).

In the meantime, thousands in Massachusetts paid a fine in 2010 for not having health insurance, also a key part of the national health law --

Boston Globe: 44,000 Uninsured Massachusetts Residents Paid Penalty In 2010
Massachusetts had the nation's highest rate of health coverage even before passage of a pioneering 2006 law requiring most residents to have insurance. Yet tens of thousands of people … go uncovered each year and pay a fine. Starting in 2014, when much of the national ­Affordable Care Act kicks in, millions of other Americans could face a similar fine, putting Massachusetts in the spotlight as a possible indicator of what lies ahead for the country. The federal plan mimics the state's law in its basic approach to expanding coverage: Make health insurance more affordable through new subsidies and a state-run insurance market. Then compel most people to buy plans and penalize those who do not. Policy advocates say the Massachusetts law lays out a finan­cial and moral incentive to get coverage. But it is not clear that this approach can be effectively replicated nationally (Conaboy, 7/6).