GOP claims Statehouse victories that could set back health law implementation

"The Democrats' ambitious health care overhaul is facing roadblocks from newly elected state officials who harshly criticized it while campaigning and who are now in a position to make good on their promises," Kaiser Health News reports. The GOP made significant political gains in Tuesday's election, taking "Governors' mansions in several states." Among the newly elected governors were Sam Brownback of Kansas, "who called the reform law 'an abomination,'" and Tennessee's Bill Haslam, who called the law "an 'intolerable expansion' of federal power."

While the newly elected officials won't be able to overturn the Affordable Care Act, "They could slow the pace of implementation, lean on congressional delegations to repeal or change the legislation, seek waivers from some of its provisions, veto state legislation related to it and appoint like-minded people to important positions, such as insurance commissioner slots." States may also decide to bide their time in implementing the law "while Republican lawmakers look ahead to the 2012 presidential election." However, if opposing governors "don't act in key areas - such as establishing health insurance marketplaces - the federal government will do it for them." State officials will also need to determine whether they will increase the power of state regulators to protect beneficiaries from insurance premium hikes, a decision that is tied to millions in federal grants (Appleby and Carey, 11/3).

Here's a look at how key health-related ballot measures and other initiatives fared in several states:

Politico: "Voters in Oklahoma and Arizona resoundingly supported ballot initiatives to opt-out of the federal health reform law." The ballot measures specifically targeted the law's individual mandate, which requires most citizens to purchase health insurance by 2014. "Oklahoma approved an opt-out ballot initiative by a 2-to-1 margin. Proposition 106 in Arizona gained 55 percent of the vote. ... Missouri voters approved a similar measure, Proposition C, with 71 percent support on a primary ballot in August" (Kliff, 11/3).

Arizona Daily Star: "In early results Tuesday, Arizona voters appeared on their way to making their own law against the national health-care overhaul. Prop. 106 would amend the state constitution, barring any law that forces people to participate in a specific health-care program, including insurance. … The Arizona Legislature put Prop. 106 on the ballot, but the impetus behind it was Glendale orthopedic surgeon Dr. Eric Novack." Some who sided with Novack "fear the federal law will give bureaucrats more power to dictate physician choices and treatment options than insurance companies and HMOs already wield, and that physicians' practice habits and fees could be locked up" (Innes, 11/2).

Meanwhile, in Colorado, "a state amendment designed to blunt the effects" of health care reform was failing as of Tuesday night, The Denver Post reports. Amendment 63, "crafted by Jon Caldara's conservative Independence Institute," was painted by opponents "as a dangerous amendment so poorly written it could have other unintended consequences. Opponents, including many medical providers, warned it could strip some oversight of medical practices and increase costs for those already insured. The 750,000 Coloradans currently without insurance would not get the help promised in health care reform" (Lofholm, 11/3).

The Denver Daily News: "Amendment 63 received 45 percent of the vote with 22 percent of precincts reporting, as of press time last night." Jon Caldara attributed the loss to the difficulty of "separating his initiative from other amendments that were so heavily opposed, including a package of three anti-tax ballot questions that were overwhelmingly defeated last night. Liberals had campaigned for voters to 'vote no on the numbers,' referring to all the ballot questions with numbers" (Marcus, 11/3).

Coloradans also rejected, for a second time, "an anti-abortion proposal that would have given unborn fetuses human rights in the state constitution," The Associated Press reports. Amendment 62 "would have granted constitutional rights at the moment of conception and would have outlawed abortions." Opponents said the initiative "also would ban fertility treatments and emergency contraception if they harmed fertilized eggs," while "[b]ackers argued 21st century DNA experiments make it imperative to give fetuses human rights" (11/2).

Californians rejected a ballot measure that "would have made their state the first to legalize marijuana for recreational use," The Associated Press/The Washington Post reports. Proposition 19, "by far the highest-profile of the 160 ballot measures being decided in 37 states," "pitted the state's political and law enforcement establishment against determined activists seeking to end the prohibition of pot." While proponents thought it a "a sensible, though unprecedented, experiment that would provide much-needed revenue for the cash-strapped state, dent the drug-related violence in Mexico by causing pot prices to plummet and reduce marijuana arrests that they say disproportionately target minority youth," members of both political parties, every major newspaper, both gubernatorial candidates, and "and all but a handful of leading politicians came out against it." Supporters blamed their defeat on the "the older, more conservative leanings of voters who participate in midterm elections and pledged to try again in two years" (Crary and Leff, 11/3).

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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.