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Health care law reverberating in battleground states

battleground states map, April 20, 2012 CBS News

(CBS News) The Supreme Court's decision Thursday to uphold key provisions of the Affordable Care Act has thrown many state governments in flux, either scrambling to ramp up preparations for increased Medicaid coverage or risking control of their insurance marketplace by banking on a new White House resident this November.

Governors Scott Walker, R-Wis., and Bobby Jindal, R-La., for example, have made clear their intentions to pursue the latter, refusing to ready their states for the health care law's provisions that will take full effect in 2014. "Every governor's got two critical decisions to make," Jindal, who frequents vice presidential rumors, said Sunday on Meet the Press. "One is do we set up these exchanges; and, secondly, do we expand Medicaid? And no, in Louisiana, we're not doing either one of those things.

"I don't think it makes sense to do those," Jindal continued. "I think it makes more sense to do everything we can to elect [presumptive GOP nominee] Mitt Romney to repeal 'Obamacare.'"

A win by Romney - the former Massachusetts governor who penned what Democrats say was the blueprint of President Obama's individual mandate - could hinge on this election's battleground states. On CBS News' Face the Nation on Sunday, Walker - governor of a particularly hot swing state - expressed sentiment similar to Jindal's, promising to "wait" until Republicans have "put in place a new president, a new Senate majority, and then ultimately repeal the law."

But a Jan. 1, 2013 deadline that requires states to have their insurance exchanges certified by the federal government poses threat to governors and state legislatures that wait too long to prepare for enormous spikes in Medicaid enrollment; if the deadline isn't met, the federal government will take control of that state's exchanges.

From special legislative sessions to ramped-up exchange efforts, local reports from these battleground states suggest political motivations will make them the most obvious barometer of the health care law's reverberations come November.

  • COLORADO - It's "full speed ahead" for health insurance expansion, reads a Denver Post article, which predicts the court's ruling will "speed insurance expansions to nearly all Coloradans, while opponents regroup for future fights, state officials and health experts said. The state will redouble efforts to prepare for 2014's growth in Medicaid enrollment, and a consumer 'exchange' where other individuals should find affordable, uniform benefits, proponents said." 

  • FLORIDA - Gov. Rick Scott, R-Fla., needs time to decide how he'll deal with the court's ruling, the Tampa Bay Times reports. However, it reads, if "the state decides to move forward, lawmakers already have placed a constitutional amendment on the ballot that would prohibit individuals or employers from being forced to obtain health insurance or from being penalized for not doing so. The ballot initiative, which needs 60 percent support to pass, is unlikely to have any real impact, however, because federal law supersedes state law. But it could bring the state and federal governments back together in a courtroom, a battle that Senate President Mike Haridopolos welcomes."

  • IOWA- Republicans and Democrats in Iowa are trying to avoid having to call a special legislative session by finding a time and place to informally determine how to implement the newly upheld health care law, reports the Des Moines Register. "State Sen. Jack Hatch, D-Des Moines, said he and Iowa Gov. Terry Branstad's chief of staff Jeff Boeyink have talked about a summit with others interested in health care. It would hopefully take place in the next two to four weeks, organized by a neutral group such as a hospital, he said. The main topic: hash over details of a state health-insurance exchange."

  • NEVADA - Facing a possible $60 million price tag from increased Medicaid enrollment over the next two years, Republican Gov. Brian Sandoval may opt out of the law's expanded Medicaid options, the Nevada Appeal reports: "Sandoval's office said the state Health and Human Services Department expects an additional 49,000 Nevadans to enroll in Medicaid as a result of the mandate to have insurance. Those are individuals not currently in the program even though eligible. Sandoval said that would cost the state about $60 million over the next biennium."

  • NEW HAMPSHIRE - With regards to the Supreme Court's decision, "New Hampshire's congressional delegation is reacting largely along party lines," the Associated Press reports, "with Republicans vowing to amend the law and Democrats praising the decision." Democratic Gov. John Lynch said in a statement: "As a state, we have been preparing to implement the Affordable Care Act and will continue doing so in a way that best fits New Hampshire." 

  • NEW MEXICO - The Santa Fe New Mexican calls the state's post-health care ruling position "limbo," reasoning that "Medicaid has a major footprint in New Mexico. It covers one in four New Mexicans to the tune of just under $1 billion in state dollars, or 16 percent of the state budget. The federal government picks up most of New Mexico's Medicaid tab, which totals $3.8 billion... Gov. Susana Martinez's administration on Thursday was still digesting Thursday's ruling and couldn't say what it would decide to push for -- a full-scale expansion of Medicaid, as called for under the law, or something else."

  • NORTH CAROLINA - Citing the Jan. 1 exchange deadline, the Charlotte Observer reports that North Carolina "risks losing control of the health insurance marketplace it has to establish under the federal law the U.S. Supreme Court upheld Thursday if it hesitates to authorize it much longer." Democratic Gov. Bev Perdue's office "said only that the governor would review the ruling to determine how it might affect Medicaid, and that she had spoken to U.S. Secretary of Health and Human Services Kathleen Sebelius." 

  • OHIO - The Supreme Court's ruling gives Republican Gov. John Kasich "the choice of whether to open Ohio Medicaid to an additional 700,000 to 900,000 uninsured Ohioans," the Dayton Daily News reports, "but it is unclear if the state will go ahead with it. Ohio Medicaid, a state and federally funded health plan for disabled and low-income people, would see its enrollment balloon by as much as 40 percent -- 3.1 million enrollees, up from the current 2.2 million -- and costs would climb $5 billion a year, according to the governor's Office on Health Transformation." 

  • PENNSYLVANIA - Gov. Tom Corbett won't yet comment on whether Pennsylvania will choose to cover more people under Medicaid, but Senate Appropriations Chair Jake Corman expressed concern that "if the decision of whether to expand subsidized medical care for the poor is truly left to the states, then it becomes a budget issue, meaning lawmakers will have input," the Associated Press reports

  • VIRGINIA - Republican Gov. Bob McDonnell, another favorite among Romney-veepstakes speculators, wouldn't weigh in on the state's next move following the court's ruling, but instead "lashed out at Obama for imposing an 'unfunded mandate' on Virginia to the tune of $2.2 billion over a decade if the state grows its Medicaid base," the Virginia-Pilot reports.

  • WISCONSIN - "We're going to wait," Gov. Scott Walker told Face the Nation about his plan for the health care law. "We have said all along that there was a legal step, there's a political step, and then after each of those steps were exhausted we will see what the future holds. But very clearly the court pointed out that the law is upheld constitutionally but it also pointed out very clearly this is a massive tax increase." The Wisconsin State Journal reports that implementing the law in Wisconsin "could insure 340,000 of the state's 526,000 uninsured residents, while business groups said the law would increase costs and health care providers debated some of its implications."

    Haley Bull contributed to this report.
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