Financial Times writes:
The federal government will step in to ensure that the Obama administration’s health care reforms are implemented in every state, Kathleen Sebelius, the health secretary, said, amid growing resistance to the changes in some parts of the US and an inability to act in others.
The article quotes Health and Human Services Secretary Kathleen Sebelius:
The way the bill is written, it really is a state-based programme with the federal government providing the back-up. So if a state opts not to set up a risk pool, we do it here at the department. If the state opts not to regulate their insurance market, we do it...
It is not a federal takeover, it’s really a partnership.
Yes, a partnership not unlike that between the Soviet Union and, say, Czechoslovakia.
The Obama administration has good reason to emphasize its conception of this "partnership:"
[S]ome big states, including California and Florida, said they did not have the legal authority to enforce the new consumer protection standards, while others face such severe budget crises that they will struggle to pay for provisions, such as the expanded Medicaid services for lower-income groups, required under the law....
Separately, more than 20 states are challenging a mandate that requires almost all Americans to have some form of insurance by 2014 as unconstitutional. A judge in Virginia has said a challenge brought by the state’s attorney-general can proceed, while Arizona, Florida and Oklahoma will soon follow in Missouri’s footsteps by holding yes-or-no referendums on the mandate....
“Federal/state relations is one of the biggest challenges to implementing healthcare reform,” said Diane Rowland, executive vice-president of the Kaiser Family Foundation, a non-partisan health policy group. “Many of the states are facing fiscal crises and they have real capacity issues."
Sebelius is undeterred:
The legal challenges will work their way through.... It doesn’t slow anything down. This is the law of the land.
Maybe, but then again, maybe not.