Twenty-six states may be expressing their opposition to parts of the 2010 health care reform law at the Supreme Court next week, but a new report suggests that, back home, most are also taking some steps to implement it.
The study, from the Commonwealth Fund, looked at provisions of the law that went into effect in 2010, the so-called "patient's bill of rights." The law gave states a choice on those matters--they could regulate insurance companies themselves or opt out and let the federal government step in. According to the report, every state but Arizona has taken some steps to establish its own system.
The "bill of rights" had 10 provisions, including rules that insurers couldn't retroactively drop coverage when a customer got sick and one that allows parents of young adults to keep their children on their insurance policies. Ten states have taken action on all of the provisions. Twelve have passed laws or issued final regulation. The rest have taken some early actions by reviewing insurance policy forms or providing unoffiical guidance to insurers. Arizona has done none of these things.
"States are responding to the federal law in pragmatic ways that suit their political culture and regulatory needs," the report says.
The report didn't analyze states' progress on the biggest responsibilities foisted on them by the law--the expansion of their Medicaid programs and the creation of state insurance exchanges. Those will be heavier lifts, and fewer states have made meaningful progress.