“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.”

“States establishing Obamacare exchanges are making a one-way, lose-lose bet. If Obamacare persists, exchanges will become bloated administrative nightmares. If Obamacare is defeated, states will have wasted time and energy that should have been directed towards that effort. Obamacare is President Obama’s problem. Don’t make it your state’s problem.”

“ObamaCare was not about fixing the insurance market. It was about seizing control of it. Thus it shouldn’t be surprising that a new analysis by the Congressional Research Service says that states can use ObamaCare to erect a de facto single-payer system by simply excluding from their exchanges every plan but a state-run ‘public’ plan. ‘There is no specific language in [the president’s health plan] that would prohibit an exchange from denying certification to every private plan that applies,’ the analysis finds.”

“West Virginia Gov. Joe Manchin, a Democrat locked in a tight Senate race against Republican John Raese, said on Fox News this morning that he would support the full repeal of health care reform if it couldn’t be fixed.”

ObamaCare’s high-risk pools are a failure, with high costs leading to few enrollees. “It’s a centerpiece of President Barack Obama’s health care remake, a lifeline available right now to vulnerable people whose medical problems have made them uninsurable. But the Pre-Existing Condition Insurance Plan started this summer isn’t living up to expectations. Enrollment lags in many parts of the country. People who could benefit may not be able to afford the premiums. Some state officials who run their own ‘high-risk pools’ have pointed out potential problems.”