What will happen to the Medicaid expansion is also up for debate. Although the Supreme Court upheld most of the health reform law in its decision earlier this year, it did say that states have the option to decide if they want to participate in the Medicaid expansion. The expansion was intended to provide health insurance to an additional 17 million people nationwide.
In response, a number of states, including Florida, Louisiana, Georgia, Mississippi, South Carolina, and Texas, have said they would not expand their programs.
Morone says as time passes, however, states opposing Medicaid expansion are likely to change their minds.
“States will realize there is all this money coming in to insure a hard population at a great rate,” he says.
For the exchanges, there’s a long way to go and not a lot of time to do it. The online markets must be up and running by October 2013.
To date, only 15 states plus the District of Columbia have firm plans to set up their own exchanges. Under the law, the federal government will set up exchanges in states choosing not to create one of their own. States planning to run their own exchanges have a deadline of Nov. 16 -- just two weeks from now -- to submit their blueprints.
“It’s possible to see delays,” says Brad Burd, general counsel for the online health insurance portal GoHealth.
Regardless of the political battles ahead, health reform is expected to march on. “I think at this point every American and company involved in health insurance ... should assume [health care reform] will go forward,” Burd says.