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States Feeling Pressure Of Healthcare Reform

April 13, 2010

Now that the federal healthcare reform bill has been signed into law, the burden is being placed on states to adhere to the legislation’s guidelines, which includes setting up exchange programs to make coverage available to the poor and elderly.

Under the health care plan, signed by President Barack Obama in March, states must establish and run exchanges that will provide coverage to those who do not qualify for Medicare or Medicaid, are unable to receive coverage from their employers, have financial hardship, or are otherwise prevented from meeting the federal mandate to enroll in an insurance program.

One of the first issues that many states are scrambling to deal with is the supplemental drug rebate, which was scheduled to begin in January. Delays in the passage of the bill and the method used to approve it meant that dates contained in the original bill could not be changed, forcing states to complete work that is technically already past due.

According to an April 12 report by Lisa Lambert of Reuters, “Many states are steaming toward the deadlines. Connecticut said last week it asked the U.S. government to put 45,000 people on Medicaid using the new criteria. It currently covers those citizens with a state assistance program and expects to save at least $53 million over the next 15 months.”

Currently, exchanges must be established by 2014. However, that could be delayed due to a pending lawsuit being filed by the attorney generals of 20 states, including Alabama, Florida, Nebraska, North Dakota, Pennsylvania, South Carolina, South Dakota, Texas, Utah and Washington. In the suit, state officials argue that it is unconstitutional to require individuals to buy insurance.

“If a person decides not to buy health insurance, that person by definition is not engaging in commerce,” Virginia Attorney General Ken Cuccinelli told Reuters on March 22, stating that the reform bill conflicts with a state law prohibiting the government to force people to buy insurance. “If you are not engaging in commerce, how can the federal government regulate you?”

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