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What's Next For Health Care In SD, MN, IA?

June 28, 2012, 1:26 PM

What's Next For Health Care In SD, MN, IA?

Each state has taken a different stand on implementing President Barack Obama's federal health care overhaul, which the Supreme Court ruled Thursday can go forward with its aim of covering more than 30 million uninsured Americans. 

Take a look at how South Dakota, Iowa and Minnesota stand moving forward.

SOUTH DAKOTA

NUMBER OF UNINSURED: Federal officials estimate 105,000 state residents are uninsured, or about 13 percent; South Dakota officials say state survey data is lower, about 9 percent.

WHERE THE STATE STANDS: Republican Gov. Dennis Daugaard has delayed work on setting up a health insurance exchange until the Supreme Court's decision.

WHAT HAPPENS NOW: Daugaard says even if the law is upheld, South Dakota won't move forward with implementing a health insurance exchange until after the November election. He hopes Republicans will win the presidency and take control of Congress and repeal the law. If the law is struck down entirely, it would jeopardize grant money that helps pay for community health centers around the state.

IOWA

NUMBER OF UNINSURED: 366,000 Iowa residents are uninsured, about 12 percent of the population.

WHERE THE STATE STANDS: The state does not have a law establishing a health insurance exchange, and Republican Gov. Terry Branstad has said Iowa will create a state-based exchange only if the law is upheld. The Republican House Majority leader says the state has already enacted several pieces of the law, including a website that helps residents find insurance, but the state has yet to comply with other requirements.

WHAT HAPPENS NOW: The Iowa Department and Health and Human Services the state Insurance Division have been planning for an insurance exchange in case the law is upheld. Democrats who control the Senate say they will push for such an exchange even if the law is rejected, but the plan would likely face opposition from Branstad and the Republican-controlled Iowa House. House Majority Leader Linda Upmeyer says the state agencies will continue to prepare Iowa until lawmakers reconvene in January. But some Senate Democrats say a special legislative session may be required.

MINNESOTA

NUMBER OF UNINSURED: 509,000 state residents are uninsured, or about 9.8 percent.

WHERE THE STATE STANDS: Minnesota has embraced the health care overhaul more than many states. Democratic Gov. Mark Dayton used a provision in the federal law to extend Medicaid coverage to more than 80,000 vulnerable adults as soon as he took office in 2011. His administration has focused on developing an online health insurance exchange envisioned as a key part of the law, securing $28.4 million from the federal government for Minnesota's planning efforts.

WHAT HAPPENS NOW: Top administration officials aren't saying how they would maintain coverage of those vulnerable adults if the federal support goes away. Any new state spending would need the help of Republicans, which appears unlikely. One top GOP lawmaker on health care issues says an overturned law would allow the state to pursue a more market-oriented approach.

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