With the defeat of Mitt Romney, Obamacare dodged a presidential repeal bullet, but serious threats to the sweeping reform of healthcare remain. In fact, given that the most important piece of domestic legislation in nearly fifty years was enacted on a party-line vote, it should not be surprising that as the bill approaches implementation, many difficult challenges are only now appearing. And, with repeal of the measure still leading in public opinion polls 50%-44%, proponents are hard-pressed to claim that the recent election answered all the questions. In fact, as the extensive reforms and regulations—13,000 pages and growing—sink into government, business and private lives, challenges will come from dozens of angles.
For starters, the success of Obamacare depends heavily on state governments, since health and welfare is constitutionally a state matter. And right now, many states are not ready to play ball. Republicans dominate the statehouses, with 30 Republican governors and, as Governor Bob McDonnell of Virginia has said, “Where there are unfunded mandates on the states or there is trampling of the 10th Amendment or undermining of federalism that hurts the state or costs us money, then we’ll fight it.” One such battleground is whether states will establish their own healthcare exchanges and so far 15 states have said they will not do so. The feds have extended the deadline for a decision by another month, hoping to persuade a few more governors, but there is very little upside to states for taking on this essentially administrative role for Washington. Read more....
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