Two of the states participating in the challenge to the Affordable Care Act, which Judge Roger Vinson voided in his dubious decision, have decided that the decision is enough to stop implementation efforts at the state level.
Greg Sargent got a statement from the Office of the Wisconsin Attorney General, J.B. Hollen, "flatly declaring the law "dead" for his state unless it's revived by a higher court, and asserting that this relieves state government of any and all its responsibilities to implement the law."
"Judge Vinson declared the health care law void and stated in his decision that a declaratory judgment is the functional equivalent of an injunction. This means that, for Wisconsin, the federal health care law is dead -- unless and until it is revived by an appellate court. Effectively, Wisconsin was relieved of any obligations or duties that were created under terms of the federal health care law. What that means in a practical sense is a discussion I'll have in confidence with Governor Walker, as the State's counsel."
It's unclear what this means in practice; a spokesman for the attorney general declined to detail what this might mean for Wisconsin residents. But it seems likely that other state officials hostile to the law may follow suit. My understanding is news organizations are canvassing state governments around the country to see if they're going to threaten to stop implementing the law in the wake of Vinson's decision. So we'll soon get a better sense of how widespread this will be.
In Florida, the state insurance commissioner is returning $1 million in federal healthcare grants paid to states to help with reform implementation.
The money would have paid for a system to provide information to consumers on the rates of large-group insurers.
"The purpose of this letter is to inform you that after deliberate consideration, I hereby rescind the acceptance of the above-referenced $1 million rate review grant, which occurred in a letter to you dated September 15, 2010. No drawdown of any of the $1 million will occur," McCarty wrote in a letter to the director of the U.S. Department of Health and Human Services' Center for Consumer Information and Oversight.
The state already reviews rates for individual and small group policies. But Florida lawmakers need to file legislation to match state law to the federal health care provisions and expand the review to large group rates, a spokeswoman for McCarty said in an e-mail. That wasn't likely to happen before Vinson's ruling, and it's certainly not likely to happen now.
Judge Vinson did not issue an injunction stopping implementation of the law, and the government is appealing the ruling, but in the meantime is within the law in continuing that implementation. Where that legally leaves these states, and the others that will be sure to follow, and how the federal government deals with them remains to be seen.