Stateline Story

More Nuance in States' Views of Health Care Law

On Monday (Aug. 30), Minnesota Governor Tim Pawlenty rejected his state's application for $850,000 under the new federal health care law to prevent teen pregnancies. At the same time, he approved a state application for $500,000 - also funded through the legislation - to promote abstinence instead.

Pawlenty, who is often mentioned among those likely to run for the Republican presidential nomination in 2012, exemplifies the fine line that many states are walking when it comes to the Obama administration's health care law. Some states are happy to take money for individual programs under the law, even as they denounce other parts of it and even fight the broader overhaul in court.

The Associated Press reports today (Sept. 1) on the latest seeming contradiction. According to the AP, seven states - Arizona, Idaho, Indiana, Louisiana, Michigan, Nebraska and Nevada - have applied for federal subsidies under the law that would help pay retiree health care bills for workers, even as they are suing the federal government to overturn the broader law.

A spokeswoman for Indiana Governor Mitch Daniels summarized the state's position this way: "Congress approved health care reform and the president signed it into law," Jane Jankowski told the AP. "Governor Daniels does not agree with it, but Indiana will seek funds that help Hoosiers when there are no complicated strings or costs attached."

On Tuesday (Aug. 31), Pawlenty went a step further than he did the day before and signed an executive order that bans Minnesota from accessing certain funds under the federal health law. Minnesota is the first state to take that step, according to The Wall Street Journal .

Even so, the order is limited and will do nothing to exempt the state from the law's main provisions. "The order isn't likely to significantly affect how the law is applied in Minnesota," The Journal reported. "It says the state can't seek further discretionary money for demonstration projects and grant funding unless the governor approves it...(but it) lasts only until Mr. Pawlenty's term ends around the end of this year."

Indeed, Pawlenty's executive order shows that states' ability to defy the federal health care law is limited, unless the courts eventually side with the states. For example, Missouri voters overwhelmingly approved a measure earlier this month to reject one of the key features of the health care law - its "individual mandate" for health insurance. But the vote does little other than send a message to Washington about voters' unhappiness with the legislation.

Stateline reported in June on the predicament facing many states that oppose the health care law. Even as governors and other elected officials - particularly those on the campaign trail - rail against the law's provisions, "hollers of protest are giving way to the blunt reality of governing," Stateline noted. Many states are taking "reluctant but real steps toward implementing the law."