Our guest bloggers are Maura Calsyn, Emily Oshima, and Lindsay Rosenthal.

As supporters of health reform, we keep hoping that Republicans will finally stop rehashing the same political fights about health care reform and start working to implement the law. And when we saw that the Republican governors submitted a letter to the President about implementation of the law, we thought it might be a good sign.

We were wrong. The letter is just political posturing and another attempt to stall health reform. It repeats the same old, inaccurate attacks on health reform before listing numerous questions that Republicans claim they need answered before they can move forward and implement health reform.

It makes sense that states might have questions about health reform implementation. The law expands Medicaid – a joint federal/state program – to cover 17 million more Americans. And states have first crack at designing and implementing new marketplaces – called exchanges – that will provide individuals and small businesses with one-stop, streamlined shopping for health insurance. If they decide not to, the federal government will step in with a federally-run exchange.

But the letter is not a serious request for information. In the two years since Obamacare became law, Republican-led states have done next to nothing to implement the law, even as most have accepted federal funding for that very purpose. Instead, the governors sat back and crossed their fingers that the Supreme Court would strike down the entire law. And now they are trying to use this request as cover for their continued inaction.

It’s difficult to summarize all that is misleading and hypocritical about the letter. It claims that states cannot make critical decisions about expanding Medicaid coverage or developing exchanges without more information from the President. But in the two weeks since the Supreme Court’s decision, a number of Republican governors have already rejected the Medicaid expansion. Why haven’t they waited for the President’s answers before making decisions that will impact millions of lives?

If more information is necessary before deciding whether a state can build its own exchange, how is it possible that many other states have made significant progress in this area? The letter even asks for extensions in applying for federal help with exchange planning – even though it’s the governors who created this time crunch.

And how can the governors keep a straight face when they plead with the President for “flexibility” while they simultaneously complain that they are “essentially being tasked with shouldering all of the responsibility” for implementing health care reform? With flexibility comes responsibility.

But this letter shows that they still aren’t accepting this responsibility. And until they do, we’ll have to keep waiting for Republican governors to roll up their sleeves and get to work implementing the law.

In a vote of 244 to 185, the House of Representatives has repealed the Affordable Care Act — just days after the Supreme Court upheld its constitutionality.

This is the 31st attempt by Congressional Republicans to eliminate the measure. The GOP has spent an estimated “88 hours and 53 minutes” since January of 2011 trying to undo the reform, an analysis by Democratic Leader Nancy Pelosi’s (D-CA) office finds, though this latest bill is expected to die in the Democratic-controlled Senate.

Prior to Wednesday’s repeal vote, Democrats introduced an amendment that would have forced members of Congress to forego the same protections that Republicans are seeking to eliminate for their constituents, including gender-based premium rating, prohibiting insurers from discriminating against people with pre-existing conditions, and allowing young people to remain on their parents’ health plans until age 26. The amendment failed along party lines, as the GOP prevailed, ignoring the consequences of repeal:

Texas Gov. Rick Perry (R) effectively defunded his state’s Planned Parenthood earlier this year by barring it and any other “abortion affiliates” from receiving funds under the Texas Women’s Health Program (TWHP). The government eventually cut off the program for not complying with the law, but Perry insisted he’d continue it — but on his own terms.

It turns out those terms mean blocking funding for anyone who even talks about abortion.

In a letter explaining the Texas Department of Health and Human Services’s proposed new rules, they have expanded their ban from “affiliates” (abortion providers or clinics attached to abortion providers) to “promoters” and those who affiliate with “promoters”:

The section also requires a TWHP provider to ensure that (1) outside the scope of TWHP, the provider does not perform or promote elective abortions and does not affiliate with an entity that performs or promotes elective abortions; and (2) within the scope of TWHP, the provider does not promote elective abortions, is physically separated from any abortion-providing or abortion-promoting entity, and does not operate under an identification mark that is registered to an entity thatperforms or promotes elective abortions.

Banning “promotion” effectively means banning any women’s health care provider who mentions the word abortion or has informational material about how a woman might be able to seek out the procedure. Banning those who affiliate with someone who promotes abortion even further broadens the number of facilities that will not be able to recieve state funds. The Dallas Observes explains how the Texas HHS defines promotion:

And what exactly does it mean to “promote” abortion? Providing a patient with a referral to a facility that performs abortions, referring to abortion as “within the continuum of family planning services,” “furnishing or displaying” information to a patient that “publicizes or advertises an abortion service or provider,” or displaying a “brand name” of a healthcare provider that performs abortions.

This is bad news for low-income women in Texas. By blocking Medicaid funding, the Texas government is effectively stopping women’s health clinics from being able to assist the poorest women who most need the help. The more sweeping the generalizations about who can provide care, the fewer options women have.

Earlier this week, in another anti-woman move, Perry said he would also turn down the Medicaid expansion available under the Affordable Care Act. Texas Medicaid recipients are disproportionately female.

Read the full letter HERE.

Throughout the GOP presidential primary, Rick Santorum argued that Mitt Romney “created the blueprint for Obamacare and advocated for exactly what Obamacare is” when he passed health care reform in Massachusetts. Now, as a Romney supporter, Santorum is still struggling to differentiate between the two laws.

While discussing the Republicans’ effort to repeal the Affordable Care Act during a radio interview with Boston’s Talk 1200 Wednesday morning, Santorum confused Romney’s Medicaid expansion with Obama’s, falsely suggesting that Obamacare opened the Medicaid program to people with incomes 300 percent above the federal poverty line (FPL):

SANTORUM: Medicaid was the principal way that Obama was going to cover more people under this health care bill. … It’s what happened in Massachusetts of course, where Medicaid was the area that was expanded to cover more people in Massachusetts and under this bill, it would clearly be the way that more people would get insurance. …. Most states cover anywhere from 75 to 100 percent of poverty. … Now under Obamacare, it’s going to go to 300 percent of poverty. So you’re talking about $90,000 income being eligible for Medicaid.

Listen:

In truth, Romneycare “included an expansion of Medicaid to children up to 300 percent of the federal poverty level” and increased enrollment caps for adults to cover an additional 92,500 people. President Obama’s law, on the other hand, expands the program to everyone with incomes up to 133 percent of the FPL. The federal government will “pay the entire cost for three years, from 2014 to 2017, and at least 90 percent after that.”

As of Monday, six Republican governors have stated they will not participate in the Affordable Care Act’s expansion of Medicaid, a decision thrown to them by the Supreme Court’s recent ruling upholding health care reform as constitutional. But Wall Street and the markets think the governors are bluffing, if the latest financial activity in the health insurance and hospital industries is any indication.

Politico reports the insurance firm WellPoint announced on Monday it will fork over $4.9 billion to purchase Amerigroup, a smaller health insurance firm which specializes in Medicaid administration. Capital is flowing into other Medicaid-focused firms as well:

Stocks for Amerigroup, Molina and Centene shot up following the Supreme Court ruling and again Monday — posting gains of 20 percent to 30 percent — following the proposed Amerigroup purchase.

Stocks for the largest chains of private, for-profit hospitals also shot up following the Supreme Court decision. And the Republican governors’ threats to withdraw from Medicaid have done little to drive them back down, said Jason Gurda, an equity analyst at health care-focused banking firm Leerink Swann & Co.

Current law prevents hospitals from turning away anyone in need of medical attention, so when those seeking medical care are uninsured, the hospitals must pick up the bill. If Medicaid expands to cover those uninsured, it would be a major boon to the hospitals bottom line. Uncompensated care cost them $39.3 billion in 2010 alone — 5.8 percent of their total expenses.

Taken together, these investments look like a bet by markets that Medicaid rolls will expand as originally anticipated. Which suggests investors view opposition to the Medicaid expansion as mere political noise — and assume the GOP governors will ultimately bow to pressure from both the public and their home state industries to participate in the expansion. When WellPoint announced its purchase of Amerigroup, WellPoint CEO James Carlson told a conference call he doesn’t see much risk of states opting out.

It’s worth noting this anticipated financial boost to hospitals and the insurance industry is a happy offshoot of Obamacare providing health coverage to as many as 16 million currently uninsured Americans. That’s 16 million Americans who will have better access to and more use of health care, will be less likely to suffer unpaid medical bills, and will be more likely to report both good physical and mental health, according to a study of those on Medicaid versus those who are insured. On top of that, the Urban Institute estimated that 21 to 45 states would actually save money by taking the Medicaid expansion because of the inflow of added federal dollars.

In just the first half of 2012, states have enacted 95 new provisions related to reproductive health and rights, including 39 new laws restricting women’s access to abortion services. A new report from the Guttmacher Institute confirms that although states have approved fewer restrictions so far in 2012 than this time last year, “55% of U.S. women of reproductive age now live in one of the 26 states considered hostile to abortion rights.”

Here is a sampling of new state abortion restrictions:

– Waiting periods: So far this year, states have considered requiring counseling and extending waiting periods for women seeking an abortion. In April, Utah enacted the most extreme waiting period law by requiring women to wait a full 72 hours between obtaining counseling and having the procedure. Twenty-five other states have waiting period laws that generally require the woman to wait 24 hours.

– Fetal heartbeat: Oklahoma and Louisiana adopted measures that attempt to use the fetal heartbeat to dissuade women from seeking an abortion. The Oklahoma law requires health providers to offer women the opportunity to hear the fetal heartbeat if they are after eight weeks’ postfertilization. In Louisiana, health providers must make the heartbeat audible, often necessitating a transvaginal ultrasound.

– Mental health: Arizona and South Dakota passed laws requiring counseling on the unsubstantiated negative mental health consequences of abortion. Nine states now require the counseling. The myth that there is a causal link between abortion and mental health issues has been largely debunked by mental health professionals.

– Public pressure helps: Only 30 percent of abortion restrictions passed by one chamber have actually been enacted so far this year, a significantly lower rate than the proportion signed into law at this point in 2011. Public pushback against the transvaginal ultrasound law in Virginia likely squashed momentum for similar provisions in Alabama, Idaho, and Pennsylvania. In addition, last November’s defeat of the Mississippi personhood amendment probably helped thwart efforts for similar laws elsewhere in the country.

A year ago, 2011 was record-breaking in terms of attacks on reproductive health. While this year is set to have fewer restrictions on the books, 2012′s figures are still higher than any year prior to 2011. As was the case last year, issues related to abortion and family planning funding were lightning rod issues in a few state legislatures. In fact, 14 of the new restrictions have been enacted in just three states — Arizona, Louisiana, and South Dakota — three of the most hostile to reproductive health.

– Steven Perlberg

Undeterred by the Supreme Court’s decision upholding the constitutionality of the Affordable Care Act and the dire need for new jobs legislation, House Republicans have spent the last two days debating the merits of repealing Obamacare and will take their 31st vote to eliminate the law on Wednesday afternoon.

Since first promising to undo health care reform in late 2009, Republicans have pledged to replace the measure with “common sense” “market based” solutions that will allow Americans to purchase coverage “across state lines” and reform the medical malpractice system. Following the first repeal vote on January 19, 2011, Republicans passed another measure instructing the committees of jurisdiction to draft up reform “replacement” legislation. In the 18 months since, the House Republican committees have hosted a series of hearings condemning Obamacare but few, if any, detailing Republican solutions to the health care crisis. As ThinkProgress’ Jeff Spross shows in the video below, that hasn’t stopped the party from continuing to insist that they will unveil their health care reform plan as soon as they repeal Obama’s law. Watch it: