Before a federal deadline today for states to declare their intentions, Associated Press reporters interviewed governors and state officials around the country, finding in some cases surprising openness to the changes. Opposition persists in others, and there is a widespread, urgent desire for answers on unresolved details.
The law Republicans have derided as "Obamacare" was devised in Washington, but it's in the states that Americans will find out whether it works, delivering promised coverage to the more than 30 million uninsured.
States have a major role to play in two of the overhaul's main components: new online insurance markets for individuals and small businesses to shop for subsidized private coverage, and an expanded Medicaid program for low-income people.
Today is the day states must declare whether they'll build the new insurance markets, called exchanges, or let Washington do it for them. States can also opt for a partnership with the feds to run their exchanges; they have until February to decide on that option.
Some glimpses of grudging acceptance across a shifting scene:
One of the most visible opponents of Obama's overhaul, Florida Republican Gov. Rick Scott, now says "if I can get to 'yes,' I want to get to 'yes.' " Florida was a leader in failed efforts to overturn the law in the Supreme Court, and a group formed by Scott ran TV ads opposing it before it passed Congress. But Scott told the AP this week he wants to negotiate with the federal government to try to help the nearly 4 million uninsured people in his state.
In Iowa, GOP Gov. Terry Branstad says he is postponing a decision because Washington has not provided enough information about key details. But his spokesman, Tim Albrecht, said Iowa is exploring a partnership exchange that could include several states. Albrecht said they're confident they can get to a state option if needed.
Ohio, like Florida and Iowa a state Obama carried in the election, is leaning toward a partnership with the federal government despite GOP officials' misgivings about the law.
In Mississippi, Republican insurance commissioner Mike Chaney formally notified Washington on Wednesday that his agency will proceed with a state-run exchange, disappointing GOP Gov. Phil Bryant, who remains staunchly opposed. Chaney says he wishes the law could be repealed, but he worries that "if you default to the federal government, you forever give the keys to the state's health insurance market to the federal government." As for trying to fight the feds, Chaney observed: "We tried that 150 years ago in the South, and it doesn't work."
In New Mexico, the administration of Republican Gov. Susana Martinez had been quietly working to put the law into place.