Health Care Fallout Continues

Many legal experts, including prominent conservatives, are casting doubt that legal challenges promised by state Republican officials will succeed in striking down federal health insurance reform. President Obama will sign the first piece of the health care legislation Tuesday (March 23), and a growing number of governors, state attorneys general and lawmakers are positioning themselves to challenge the new laws in court.

One tactic some states are taking is to try to "opt out" of the law, an approach taken by Idaho and Virginia. (Later this year, Arizona voters will decide whether they, too, want the state to exempt itself from the federal law.) Several legal experts told National Public Radio that those attempts are likely doomed.

"The notion that a state can just choose to opt out is just preposterous," former Reagan administration Solicitor General Charles Fried told NPR. "One is left speechless by the absurdity of it."

And Michael McConnell, a former federal appellate judge, told the Washington Post the laws were moot. "If the federal bill is constitutional, then the state laws will be of no legal effect. If the federal bill is unconstitutional, then the state measures will be unnecessary," said McConnell.

State officials are still grappling with the fallout of the health care changes. Here's a sampling:

Arizona: Recent budget cuts signed by Governor Jan Brewer could jeopardize as much as $6.96 billion in federal Medicaid money, because the federal legislation would require states to keep up their Medicaid spending, says the Arizona Republic .

Arkansas: Governor Mike Beebe, a Democrat, said the state would abide by the new laws, despite calls from his Republican opponent to challenge the law, says the Arkansas News Bureau .

California: Concerns remain about whether there are enough primary care physicians to handle the influx of patients and the legislation's emphasis on preventive care. Much of the insurance expansion depends on Medicaid, and Medi-Cal, California's Medicaid program, pays low rates to doctors, the Sacramento Bee reports. 

Maryland: The General Assembly is preparing for an influx of Medicaid recipients by moving forward with anti-fraud measures, according to the Baltimore Sun . "If we are going to expand Medicaid, it is that much more important that we have the right tools in place," explained Lieutenant Governor Anthony Brown.

Mississippi: Governor Haley Barbour, head of the Republican Governors Association, says Mississippi ought to challenge the federal law, even if state Attorney General Jim Hood refuses to do it, the Clarion Ledger writes.

Texas: The proposed Medicaid expansion at first looks like a great deal for Texas, because the federal government would pick up the entire tab at first. But the expansion would eventually cost the state an estimated $370 million in 2020, according to the Texas Tribune . A spokeswoman for Texas Governor Rick Perry told the Dallas Morning News , "This doesn't end cost-shifting, it increases costs — more money will flow through this system, costing taxpayers even more."



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