The Scan — October 10, 2013

Rep. Bill Young, R-Fla., announces he will retire next year, putting his Gulf Coast seat in play for the first time since he was elected in 1970.
National Journal
Meghan Mccarthy
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Meghan McCarthy
Oct. 9, 2013, 5:04 p.m.

While House Re­pub­lic­an lead­ers have stepped up their rhet­or­ic about dis­mant­ling the new health care law, the GOP wave that ex­ten­ded to gov­ernor’s man­sions and state le­gis­latures will provide crit­ics of the law ample op­por­tun­ity to put their stamp on the meas­ure at the state level.

Nearly all of the Re­pub­lic­ans who won gubernat­ori­al races cam­paigned against the health care law, and at least two new GOP gov­ernors, Sam Brown­back of Kan­sas and Matt Mead of Wyom­ing, have said their states should join in leg­al chal­lenges to over­turn the in­sur­ance cov­er­age man­date in the law.

If Re­pub­lic­an gov­ernors drag their feet too much, spe­cific­ally on in­sur­ance ex­changes, the law per­mits the fed­er­al gov­ern­ment to take over where states fall be­hind. But with the Health and Hu­man Ser­vices De­part­ment already tasked with the huge role of writ­ing reg­u­la­tions for each pro­vi­sion of the law, hav­ing to run ex­changes and oth­er pro­grams for states with po­ten­tially hos­tile gov­ern­ments will add to the chal­lenge.

The turnover among gov­ernors means there is also the po­ten­tial of a shift in the makeup of in­sur­ance com­mis­sion­ers.

After passing med­ic­al loss ra­tio reg­u­la­tions that lib­er­al groups her­al­ded as tough on in­sur­ance com­pan­ies and good for con­sumers, the Na­tion­al As­so­ci­ation of In­sur­ance Com­mis­sion­ers may find it­self with a more con­ser­vat­ive out­look come Janu­ary. NA­IC still has much to do with the health care law, most not­ably in de­term­in­ing what in­sur­ance ex­changes should look like.

The as­so­ci­ation might be fa­cing a new round of elec­tions for its 2011 lead­er­ship if newly elec­ted GOP gov­ernors in Iowa and Flor­ida ap­point new com­mis­sion­ers over NA­IC Pres­id­ent Susan Voss and Pres­id­ent-elect Kev­in Mc­Carty. NA­IC VP Kim Hol­land, Ok­lahoma’s cur­rent in­sur­ance com­mis­sion­er, was ous­ted Tues­day in fa­vor of GOP con­tender John Doak.

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