The Looming State-Federal Showdown

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When it comes to health care, conservative state legislatures seem to be happily on a collision course with the Obama Administration. Passing statutes that defy federal law and exempting themselves from the new health reform overhaul, these states are begging for a fight. They will get one eventually – in most cases, in the form of drawn out court battles just now beginning – and only one side will prevail in the end.

Indiana is latest to take a stand against the federal government, passing a law recently that forbids Medicaid dollars from flowing to any entity or facility that performs abortions. According to a letter Centers for Medicare & Medicaid Services head Don Berwick sent to Indiana on Wednesday, this action runs counter to federal Medicaid law, which says Medicaid recipients can get covered services from any qualified health care provider.

Indiana has 60 days to appeal Berwick’s directive that it change its law to comply with federal rules. The state appears to have no intention of backing down and could be jeopardizing $4 million to $4 billion in federal funds as a result. Planned Parenthood, which stands to lose some $1.3 million annually according to the Indianapolis Star, is challenging the Indiana law in court.

Meanwhile, Kansas legislators have also voted to yank funding from Planned Parenthood and Politico reports that some lawmakers in Texas, Tennessee and North Carolina also want to follow suit.

Elsewhere, states are suing the federal government in district courts over the constitutionality of the Affordable Care Act. Some of these states are also passing laws or ballot measures exempting citizens from the ACA. States don’t technically have the power to usurp federal law, but this is another set of cases that may ultimately be decided in courtrooms across the country.

Court battles are not fast moving, meaning these state vs. fed battles are likely to come to a head just as the 2012 presidential election season really heats up – not to mention the state level races and congressional campaigns that will be underway at the same time. Do we have a series of Scott Walker moments to look forward to? Will any of these state-level battles become real national news, with GOP presidential candidate weighing in and causing state conservatives and the Obama Administration to dig their heels in even deeper? Will Indiana’s stance on Planned Parenthood or other states’ attempts to defy federal law become presidential campaign issues or come up in any of the debates? With federalism such an important issue for Tea Partiers, this seems very possible.

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