David Jones and I have an op-ed at the Washington Post detailing the results of our examination of five states—Florida, Michigan, New Hampshire, North Carolina, and Utah—and how they’re likely to respond to a government defeat in King. Here’s a taste:
What we found was both striking and worrisome. Dozens of interviews conducted by our research team with political leaders, agency officials and advocacy organizations in those states indicate that the states are almost completely underprepared for the Supreme Court’s decision in King.
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In each of the five states, political resistance to new exchanges is expected to be fierce. The speaker pro tempore in the Florida House of Representatives, for example, told us that “Florida has no desire to create a state-based exchange,” even if the government loses in King. Republicans’ recent rejection of Medicaid expansion suggests that they aren’t bluffing.
Legislators in Michigan believe that any discussion of a state exchange could spur a resurgence of the tea party, whose opposition doomed Republican Gov. Rick Snyder’s original effort to create an exchange. And the leader of the North Carolina Senate is an ardent foe of the Affordable Care Act.
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[T]he bottom line is grim. The states aren’t prepared for King, and any debates over whether to create state exchanges will be turbulent and difficult. In the meantime, millions of people stand to lose their health insurance.
To those of you attending AcademyHealth’s Annual Research Meeting in Minneapolis, David and I will be discussing King with Sara Rosenbaum and MaryBeth Musumeci on Sunday at 4:30pm.