States That Refuse To Implement Reform Are Inviting A ‘Government Takeover’

Greg Sargent is reporting that at least one of the 26 states that successfully challenged the government over the individual mandate is now using Judge Roger Vinson’s decision as an excuse to stop implementing reform:

“Judge Vinson declared the health care law void and stated in his decision that a declaratory judgment is the functional equivalent of an injunction. This means that, for Wisconsin, the federal health care law is dead — unless and until it is revived by an appellate court. Effectively, Wisconsin was relieved of any obligations or duties that were created under terms of the federal health care law. What that means in a practical sense is a discussion I’ll have in confidence with Governor Walker, as the State’s counsel.”

As Sargent points out, it’s unclear what this practically means. After all, the 26 states have already received money from the law and, despite what their respective politicians say on the T.V., they’re busy implementing the measure. Politico’s Sarah Kliff notes:

In Texas, a conservative state legislator is pursuing legislation that would authorize the state to build infrastructure for a health insurance exchange. In Kansas, the Republican insurance commissioner is waiting to see whether her state will win a competitive grant from the federal Department of Health & Human Services, despite newly-elected Gov. Sam Brownback’s strong opposition to the health overhaul. And in Iowa, where Gov. Terry Branstad is party to the Florida lawsuit, the Iowa State Legislature is finalizing recommendations for how to best implement the law in their state. […]

All told, each of the 26 states that are party to the federal lawsuit in Florida against health reform have received some level of funding to implement provisions of the Affordable Care Act. Observers on both sides of the aisle expect implementation to move forward largely despite Monday’s ruling.

I suspect that state lawmakers who refuse to implement the law will face the same conundrum as conservatives who firmly avoided establishing state-based high risk insurance pools or are now refusing to consider building the exchanges: they will cede the implementation of all of these elements to the federal government. That is, by refusing to implement the measure themselves, Republicans are inviting the federal government to step in, thus bringing about the very kind of federal intrusion that seek to avoid.