Sharp divisions persist over law's future.

• Author: Cauchi, Richard
• Position: HEALTH REFORM: SPECIAL REPORT

Changing the nation's health system has become a lightning rod for partisan disagreement, although state legislatures have seen far less paralysis and, at times, more thoughtful debate than has Congress.

Within hours of the president's signature, 14 states had filed federal court challenges to the new law. By January 2011, 28 state attorneys general or governors were pursuing repeal efforts.

Legislators stepped into the arena as well. There are now 19 state laws, including three constitutional amendments, opposing certain provisions. Typically, they ban state government involvement in requirements to purchase health insurance. Similar legislation failed in 27 states.

These high-visibility opposition or "opt-out" moves reflect the strong partisan divide on the new federal law, critically labeled "Obamacare" by opponents in press releases and floor debates.

The change Arizona lawmakers approved in their constitution "no law or rule shall compel any person or employer to participate in any health care system"--became a model for bills proposed in more than 40 states.

"The majority in Arizona's Legislature has little faith that the federal health reform law will benefit our citizens' health or lower health care costs," says Senator Nancy Barto (R), the lead sponsor. "Instead, we expect to advance health reforms that lower the high cost of care and allow more insurance options whether or not the Supreme Court upholds the federal law."

New Jersey Assemblyman Herb Conaway (D) supports the law but is not surprised by the opposition to it. "Reform often comes in fits and starts," he says. "A reform of this scale and magnitude will not proceed without challenges and difficulties."

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