“The federal government is demanding that states spend precious time in upcoming legislative sessions to set up massive new bureaucracies in anticipation of spending billions of dollars to implement ObamaCare… But there are ways states can protect themselves from being swamped by these federal demands.”

“First, ObamaCare’s state-side implementation is going to be very difficult and very complex. Even big, liberal states like California are going to have trouble keeping up with the law’s requirements. Second, that complexity is going to set up a system that’s 1) going to create a lot more interdependence between the government and the private sector and 2) begging to be gamed. That’s presumably why private firms, especially in the consulting sector, are already investing heavily in staff who can explain what the government’s doing and, presumably, how to take advantage of it. “

“The healthcare reform law flunks the test of real healthcare reform. Real reform would: encourage providers to offer higher-quality care at lower costs; reduce the cost pressures that threaten to bankrupt Medicare and Medicaid; and give every American access to more options for quality insurance. To enact real healthcare reform, and help to restore fiscal balance to the nation’s budget, the next Congress should pursue substantial changes to the Patient Protection and Affordable Care Act (PPACA). We recommend the following five healthcare objectives for the 112th Congress.”

“Mr. Obama declared at the time that ‘uninsured Americans who’ve been locked out of the insurance market because of a pre-existing condition will now be able to enroll in a new national insurance pool where they’ll finally be able to purchase quality, affordable health care—some for the very first time in their lives.’ So far that statement accurately describes a single person in North Dakota. Literally, one person has signed up out of 647,000 state residents. Four people have enrolled in West Virginia. Things are better in Minnesota, where Mr. Obama has rescued 15 out of 5.2 million, and also in Indiana—63 people there. HHS did best among the 24.7 million Texans. Thanks to ObamaCare, 393 of them are now insured.”

“The Patient Protection and Affordable Care Act (PPACA) will place unprecedented fiscal pressure on states, several of which are already suffering from multibillion-dollar budget deficits. Although many of the law’s most costly requirements will not take effect until 2014, some states are bracing for billions in new spending, while others have already started to take costly steps toward implementing the new law.”

The state of Texas is considering ending their Medicaid program entirely rather than dealing with new Medicaid costs from ObamaCare. The law’s “maintenance of effort” provisions prevent Texas from modifying eligibility requirements or implementing most other cost-saving measures. This could require new federal spending to offset the reduction.

Since the subsidies for the uninsured don’t begin until 2014, ObamaCare creates high-risk pools to help the uninsured get coverage. This program is so poorly designed and ill-conceived that instead of insuring hundreds of thousands of people, as expected, only about 8,000 people have coverage in the program.

“A conservative group of healthcare analysts today welcomed the intention of the new House Republican majority to immediately pass a bill repealing President Obama’s health reform law. After that’s done, though, the analysts suggested the Republican leaders get to work on a more realistic strategy to destroy the president’s signature piece of legislature.”

“Voters in Oklahoma and Arizona resoundingly supported ballot initiatives to opt-out of the federal health reform law, while Colorado voters appeared headed to rejecting a similar measure.”

ObamaCare directs states to set up exchanges to manage its new insurance subsidy system. “But states view the project as an enormous undertaking, requiring them to design a system, develop the information technology and put it into action in just three years amid tight budgets.”