President Obama’s national health care reform initiative is in jeopardy even before serious negotiations to pass legislation have begun. Republican opponents in the House and Senate pose one obvious threat. In addition, some states are considering opting out of the plan—before a funding mechanism is set, before the number of people to be covered is decided, before any real determination of what the revamped health care system will look like. Click title to read more…

Arizona took the first serious steps to separate itself from passage and implementation of any national health care plan when its House and Senate passed HCR 2014, the Arizona Health Care Freedom Act. This resolution calls for a voter referendum in 2010. If passed, the measure would override any federal law, rule or regulation requiring individuals or employers to participate in any particular health care system.

This “nullification” law would preserve Arizona’s ability to keep its current state-run health programs as well as its ability to continue regulating health care plans within its borders. Currently, the state’s chief coverage initiative targets indigent residents through the Arizona Health Care Cost Containment System (AHCCCS), which requires patients to seek services within a network of “preferred providers” determined by the state. The “freedom of choice” advocated under the Obama plan would override this state requirement in favor of allowing patients to choose their own doctors and hospitals.

Arizona is not alone in its efforts to sidestep participation in national health reform. Indiana, New Mexico, Minnesota, North Dakota and Wyoming are considering similar measures based on what some legislators see as federal interference in the traditional role of states as regulatory bodies. The dissenters see “Obamacare”—the current derisive term used by opponents to belittle the plan—as a Washington power grab that will undermine state authority and the ability of local politicians to raise money from nationally regulated groups.

Success of these secession efforts could derail a national plan’s goal of standardizing care and reimbursement rates. This failure could have a dramatic impact on hospitals, doctors and other health care providers, who may face a patchwork of regulations issued by a variety of regulatory authorities at varying levels of government. State nonparticipation could also undermine a national plan’s effectiveness in controlling costs by creating exceptions to national deals with drug and device companies, health care organizations and public and private insurers. Ironically, the prospect of loss of control of measures in place to contain health costs is one of the same fears driving Arizona’s secession efforts.

While the US Constitution contains clear language giving the federal government power over the states in regulating such matters as “interstate commerce”—which certainly includes health care—contrarian states are pressing ahead (at varying speeds) fueled by past instances of states successfully fending off federal rules. For example, 3 states have passed medical marijuana laws permitting patients to seek a doctor’s permission and the state’s help in obtaining a drug that the federal government has deemed illegal for use under any circumstances.

More than 20 states have passed legislation refusing to implement still-undetermined rules stemming from the 2005 Real ID Act, which sought to mandate national security and authentication procedures for drivers’ licenses and ID cards issued by states to be accepted by airlines and federal agencies. The federal government is now modifying—and may altogether abandon—its plans for forcing states to relinquish their role in determining how residents can obtain identification cards and drivers licenses.

Arizona has a history of resisting federal initiatives that may increase its likelihood of success in leading a rebellion against national health reform. The state continues to refuse to implement the federal daylight savings plan, and was the last in the country to recognize the Martin Luther King, Jr, holiday.

If Arizona’s efforts continue to attract press coverage and the attention of other state legislatures, its opposition could further amplify challenges for Obama’s health care plan. The American Legislative Exchange Council, a national organization of 1,800 state legislators (albeit mostly Republicans), has endorsed a resolution opposing a Medicare-modeled federal health plan and a national health insurance exchange along the lines of Obama’s “public option.”

Hospitals, drug companies and health insurance providers will need to monitor the status of Arizona and other states in nullifying the most significant change to the health care system since Medicare. Lobby and use your influence to ensure that any national initiative applies to all states, all providers, and all patients. Otherwise, the potential provider benefits of a uniform regulatory framework, economies of national scale and progress toward universal coverage will evaporate.

Source: By James Bradford, Senior Political Advisor, Sg2

Click here to view original article.