After Obamacare's rocky rollout, lawmakers in state capitals around the country are back in session for the new year and once again going after the new health law, trying to stamp it out or obstruct its implementation within their borders.
Prompted by stories of millions of Americans who have lost health plans that don't meet Obamacare's standards, legislatures in at least a half-dozen states are poised to "nullify" or at least prune back key portions of the Affordable Care Act.
"They're taking matters into their own hands," said Joshua Withrow, legislative affairs manager for FreedomWorks, a conservative nonprofit in Washington.
Efforts to gut the health care law are nothing new. Since Obamacare's passage in 2010, "members of at least 47 state legislatures proposed legislation to limit, alter or oppose selected state or federal actions" related to the overhaul, according to a tally kept by the National Conference of State Legislatures.
But as President Obama forges ahead with his overhaul, reports of rising premiums and canceled plans have reignited state-level strategies to weaken the law.
In South Carolina, the Freedom of Health Care Protection Act would prohibit state agencies or officials from promoting or enforcing the health care law. It also would dole out a tax deduction equal to the amount a state resident had to pay to satisfy any penalty under Obamacare for lacking insurance.
Lawmakers in Ohio, Mississippi and Missouri have filed legislation that would bar insurers from accepting federal subsidies that could trigger the "employer mandate" requiring larger firms to provide health coverage.
And in Tennessee, a bill would prevent insurers from accepting so-called "risk corridor" payments to insurance companies — a type of safety net in the health care law that's been derided as a "bailout" for insurers that attract too many unhealthy customers.
Supporters of Mr. Obama's reforms say state lawmakers are trying to thwart Americans from gaining health insurance they desperately need, as millions of Americans gain private coverage — often with the help of government subsidies — or Medicaid coverage because of the reforms. Consumers have until March 31 to sign up to be covered for this year.
Others say the nation's first brush with Obamacare has proven to be a disaster that requires action.
In West Virginia, lawmakers proposed a resolution that would ban the state from doing business with CGI Federal, the lead contractor on HealthCare.gov website that was plagued by glitches early on.
The 2014 legislative period has just begun, so the latest anti-Obamacare trends should emerge by March or April, said Dick Cauchi, a health program director at the NCSL, which studies state legislation.
He said South Carolina has taken the most tangible steps to stifle Obamacare. The state House passed its bill, and the Senate is poised to take it up soon. Republicans control both houses and the governor, Nikki Haley, is also a Republican and critic of Obamacare.
State officials said earlier this month that about 24,000 South Carolinians had enrolled in the federal Obamacare website through late December, in a state where it is estimated there are 700,000 residents without health insurance.
The South Carolina bill is not a true "nullification" bill, in which a state tries to invalidate a federal law, even if the spirit of South Carolina's own John C. Calhoun — a leading 19th-century practitioner of trying to bat away federal laws that the South did not like — looms above the debate.
Under the Constitution's Supremacy Clause, states cannot nullify federal laws, said Randy Barnett, a professor at the Georgetown Law Center.
"But neither can the federal government 'commandeer' state governments to do its bidding," he said. "So, while states have to obey federal laws — like, for example, pay minimum wage [rates] or obey environmental regulations — they cannot be made to implement or enforce federal policies against their own citizens. So the most a state can do to 'obstruct' a federal law is to do nothing to assist."
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