“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.”

New insurance exchanges are supposed to make insurance companies more responsive to market forces, but will instead give government control over the market. “In theory, they will expose health insurance customers to greater competition while protecting them through regulation. Insurers participating in the exchanges, for example, will face strict limits on how they can price their premiums according to individual risk factors. In practice, they will likely prove difficult to design and implement, and may ultimately undermine the country’s quality of care. No matter what, there is little doubt that the exchanges will fundamentally alter the health insurance landscape across the states.”

State budgets are already in the red, and ObamaCare saddles them with new costs for Medicaid expansions and to establish and implement new insurance exchanges.

A consequence of the government take-over of the health sector is the vast new influence that health lobbyists will have. On the federal and state level, influence-peddlers will become more important, violating a key campaign promise that President Obama would reduce corporate influence in government.

“I note with special sadness that first and foremost amongst the bill’s consequences will be the probable demise of the Healthy Indiana Plan (HIP). This program is currently providing health insurance to 50,000 low-income Hoosiers. With its Health Savings Account-style personal accounts and numerous incentives for healthy lifestyle choices, it has been enormously popular and successful. Obamacare’s expansion of Medicaid, soon to cover one in every four citizens, will not only scoop up most of HIP’s participants, but will also cost the state between $3.1 and $3.9 billion over the next decade. It is hard to see how my successors as governor will be able to avoid a steep state tax increase to pay for it.”

HHS Secretary Kathleen Sebelius claims ObamaCare is a partnership between the federal government and state governments, not a national take-over. Given the vast new powers claimed by Washington after ObamaCare, the pleas of cooperation ring hollow.

Indiana’s proven health reforms are about to be overturned by ObamaCare’s Washington-led directives. “A key part of American federalism is states’ ability to serve as laboratories where the consequences of various programs can be explored without committing the entire nation to what may turn out to be expensive blunders. For instance, Wisconsin successfully took the lead on welfare reform in the early 1990s, setting the template for national bipartisan legislation in 1996 that lifted millions of women and children out of poverty. But in health-care reform, President Obama and congressional Democrats didn’t wait for state experiments to run their course. State reform efforts—on the left and right—were still in their earliest stages in March 2010, when Congress passed the Patient Protection and Affordable Care Act, committing the nation to trillions of dollars of new health-care spending. The consequences of this rush to national reform could be dire.”

“Missouri voters dealt Obamacare a significant setback yesterday, approving a statewide ballot measure by an overwhelming 3-to-1 margin. The vote was the first time citizens had an opportunity to cast a ballot on the unpopular health care law. Missouri’s measure prohibits the federal government’s enforcement of the individual mandate to buy health insurance. The victory sends a strong message about Obamacare in a bellwether state.”

Missouri voters overwhelmingly passed a referendum prohibiting ObamaCare’s individual mandate. About 3 in 4 voters rejected this key provision, which would force individuals to buy health insurance or pay a tax.