One year later: states have moved ahead despite uncertainty and opposition.

• Author: King, Martha P.
• Position: FEDERAL HEALTH CARE REFORM

[ILLUSTRATION OMITTED]

Passage of federal health reform a year ago created a lengthy to-do list for states. Many already had a jump on the federal government, and every state has made some progress in implementing the new law.

Several states already had experience creating high-risk insurance pools, requiring insurance companies to cover young adults on their parents' insurance plans, and providing coverage for poor people through optional Medicaid expansions.

Every state has done something to move ahead on the new federal requirements and has accepted federal planning funds. By the end of 2010, at least 33 states had formed a task force, commission or other special group to study and guide its implementation of health care reform. At least 12 states already had issued a preliminary report.

MIXED SUPPORT

State actions don't necessarily equate with support for the new federal law, however.

Twenty-five states joined Florida in a successful leg al challenge to the individual insurance mandate, with a U.S. District Court ruling in Pensacola that declared the entire law unconstitutional on Jan. 31. Eight states enacted laws or passed initiatives in 2010 opposing certain requirements or refusing to enforce certain provisions. Five other states adopted resolutions to protest federal provisions.

As conflicting court rulings make their way toward the U.S. Supreme Court, states continue to face deadlines under the law and most lawmakers, even those who oppose the federal law, realize they need to do something, if only to understand the issues and the stakes.

In the meantime, states face deadlines under the law, and most lawmakers, even those who oppose the federal law, realize they need to do something, if only to understand the issues and the stakes.

"There are many of us who don't believe the [law] will solve the problem of uninsured people in our state, and Wyoming is joining Florida's lawsuit," says Wyoming Representative Elaine Harvey, the new health committee chair.

"However, it's the law of the land until Congress repeals it and the president signs a repeal. Until that happens, we will study each issue as well as the deadlines."

[ILLUSTRATION OMITTED]

In some states, there are both support and resistance to the new law. In Colorado, Attorney General John Suthers joined the Florida suit, while outgoing Governor Bill Ritter issued a report in December 2010 saying that "by expanding access, improving quality and containing costs, this...