Stateline Story

Fallout from Florida Health Care Reform Ruling

STRIKE TWO: Republican governors roundly applauded the Florida federal court decision Monday, Jan. 31, finding the Obama administration's health care reform law unconstitutional. "Never before has Congress required that everyone buy a product from a private company,'' U.S. District Judge Roger Vinson wrote in the Florida-led lawsuit, The Miami Herald reported . It was the second ruling against health care reform's individual mandate, with a Virginia judge calling it unconstitutional in December. Two other federal judges have upheld the law, which pits 26 states against the federal government.

ON THE CHOPPING BLOCK: Democratic governors Jerry Brown of California and Andrew Cuomo of New York are proposing billion-dollar cuts in Medicaid spending, The New York Times reportedGeorgia 's new GOP leader, Governor Nathan Deal, has proposed ending dental, vision and podiatry treatments for adults and South Carolina wants to eliminate hospice care. Other states are considering cuts in prescription drug benefits and mental health services, according to the Times . The cuts come as states confront a $125 billion budget gap, evaporation of federal stimulus money and a moratorium on reducing swollen Medicaid rolls.

ARIZONA WAIVER SEEN TRIGGERING STAMPEDE:  Arizona Governor Jan Brewer recently asked the federal government for a waiver to roll back Medicaid eligibility and drop coverage for 280,000 people. Brewer's move aims to shave $542 million from a budget projected to be $1.2 billion short for the coming fiscal year. According to Bloomberg , Arizona's action could touch off a flood of similar requests from other states. "There are other states contemplating" requests for waivers, Bloomberg quoted Dan Mendelson, the chief executive officer of the consulting firm Avalere Health LLC saying. "Letters are coming from some big states reaching the point of no return." An article in Kaiser Health News makes similar predictions. While Republicans in Congress say they would like to give states the leeway they request, Democrats prefer to extend Medicaid aid to 2014, according to the article. 

ALASKA WANTS TO HIT PAUSE: Although GOP Governors applauded this week's strike against federal health care reform, most vowed to forge ahead with implementation.  Alaska Governor Sean Parnell was an exception. According to The Associated Press , Parnell called on the federal government to suspend implementation of the law until the U.S. Supreme court rules in the case. So far, Alaska is the only state that has refused to accept federal money for creating a health benefit exchange, a key component of the law.

EXCHANGE WORK PROCEEDS: In Texas and Iowa , conservative lawmakers are pushing bills to launch  health benefits exchanges. The Kansas insurance commissioner is seeking a federal grant for the work. Yet, all three states are party to the federal court case seeking overturn of the health care reform law. "I think you have a number of states who say, I may not like this law, but I sure as heck would rather design the exchange myself than leave it to the federal government," Politico reported Dean Rosen, a health lobbyist with Mehlman Vogel Castagnetti, Inc., saying. Republican Governor Scott Walker of Wisconsin , who also signed onto the court case, called for an "Office of Free Market Health Care" to launch a health benefits exchange, according to a governor's office release . While fulfilling its responsibilities under the Affordable Care Act, the new office would also "explore all opportunities and alternative approaches that would free Wisconsin from establishing a health benefit exchange, including federal waivers."