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Chaotic Changes in the States

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Posted on Monday, Jun 25, 2012

The majority of states have engaged in some form of litigation against the Patient Protection and Affordable Care Act (PPACA). While many have joined the effort to overturn the law at the U.S. Supreme Court, most are now moving forward with implementing components of the law. States have issued new regulations, passed new laws, or both to comply with PPACA.

But actions from one state to another vary widely. For instance, one of the cornerstones of the law is the creation of a state-based health insurance exchange marketplace, scheduled for launch in 2014. To date, only 28 states and the District of Columbia have taken steps to create their own exchanges. Those that fail to meet the deadline will have to cede their markets to the federal government.

Several states are showing their reluctance to implement provisions of the health reform law by refusing or returning federal grants to help fund mandates of the law. Texas, Kansas, Florida, Wisconsin, Ohio, and other states have all returned funds.

There is one state that is holding out on implementing any part of the law: Arizona has taken no action, and the federal government could take action to penalize the state or compel it to act.

If the Supreme Court rules that PPACA is unconstitutional, it remains unclear what will happen with the new state laws and regulations. This leaves American businesses and consumers uncertain what lies ahead for health care reform.