Though their campaign to repeal Obama’s Affordable Care Act has failed to gain much traction in Congress, Republican officials are already seizing upon ways to opt out of the new health law. At least 15 states—all but three led by Republicans—have decided against creating insurance pools for Americans with pre-existing conditions, forcing the federal government to step in and establish the high-risk pools itself. By contrast, at least 28 states—all but seven led by Democrats—will help the federal government by creating the pools themselves. It’s the first major decision for states to make under the new law. And the Republican-led refusals are the latest sign that red states will be far less willing to play nice as health reform gets underway.
In opting out of the high-risk pools, state officials criticized the federal government for not providing enough money to set up the program, claiming that states would end up being responsible for the shortfall. Texas Governor Rick Perry, for one, faulted the federal government for pushing "the aggressive implementation" and "the lack of assurances on financial solvency of the program." Such barbs echo other Republican-led attacks on the new health law, including the big expansion of Medicaid that states will help support—backed by a huge injection of federal money.