Should conservatives help implement the Affordable Care Act, the health-care law they detest?
For months, it seemed that Republican state leaders hoped they would not need to decide. Perhaps the Supreme Court would overturn the law. It didn't. Then perhaps Mitt Romney would beat President Obama and slow or halt the application of the law. Romney will get no such opportunity. Now conservative governors are facing their first deadline to decide how much they will cooperate with a federal government that will push forward. States must tell the Department of Health and Human Services (HHS) whether they will set up their own health-insurance "exchanges" markets on which the uninsured will be able to buy coverage or punt some or all of that responsibility to the federal government.
According to the Kaiser Family Foundation, more than a dozen states have already said that they will not participate in building the exchanges, which means HHS will do it for them. A similar number of states have yet to decide. Those that procrastinated might not have much choice; HHS has been at work since the law passed in 2010, and they haven't been. But anti-Obama politics and simple aversion to the law also no doubt tug conservative governors and state legislatures away from cooperating with any part of it.