In a news release, the governor said that conditions were too unstable to recommend creating the kind of exchange stipulated by President Obama’s health care overhaul. That law intended individual states to set up their own exchanges, meant to assist people who purchase personal insurance plans.

But Governor Daugaard feels that the U.S. Supreme Court might strike down the health care reform law, or that it might be repealed by Congress, though he’s hoping for the former outcome. Despite this, he said, his state will apply for a federal grant to help create such an exchange if South Dakota is eventually required to do so.

The decision, made by U.S. District Judge Tanya Walton Pratt, in Indianapolis, agreed with the federal viewpoint that individual states may not disqualify Medicaid providers just because they also happen to be abortion providers, nor may the states do anything to restrict the freedom of Medicaid patients to select their own health care providers.

Bryan Corbin, the spokesperson for the Indiana attorney general’s office, said that the state will probably appeal this ruling.

The law, which went into effect last month, made Indiana the first state in the country to refuse to disburse Medicaid funds meant to be used for breast exams and Pap smears to Planned Parenthood. The organization, which provides health care to about 9.300 Indiana clients who receive state-federal health insurance for low-income and disabled Medicaid recipients, lost about $1.4 million because of that legislation.

The state’s argument was that federal law disallows Medicaid-covered abortions in most circumstances, and that such procedures are indirectly funded because financial statements from Planned Parenthood show that Medicaid funds are comingled with revenue from other sources. The state believes that this means the state-federal health insurance plan for low-income and disabled people might therefore be subsidizing some of the overhead costs for space where abortions are performed.

Pratt’s ruling said that Planned Parenthood would feel “dire financial effects” because of the law, and that the defunding meant basic health care would be denied to Medicaid patients who use the facility.

Planned Parenthood of Indiana has actually been running without Medicaid funding since Indiana Governor Mitch Daniels signed the law into force on May 10th, but wasn’t forced to stop seeing Medicaid patients until last week, when the donations from private sources, used to cover those patients’ bills, ran out.

Nationally, less than 3% of the medical services Planned Parenthood provides are abortions, or abortion-related.

Her, reason, she wrote in her veto letter, included the fact that directing the governor to sign such an agreement would violate the separation of powers requirement outlined in Article 3 of the Arizona constitution.

While Governer Brewer was wielding her veto stamp, she also vetoed Arizona’s so-called “birther” bill, which would require political candidates to provide specific documentation (beyond their short-form birth certificates) in order to appear on ballots in the state, and another bill that would have authorized students to carry guns on campus.

What follows are a two numbered excerpts from the speech:

1. “Our approach lowers the government’s health care bills by reducing the cost of health care itself.

“Already, the reforms we passed in the health care law will reduce our deficit by $1 trillion. My approach would build on these reforms. We will reduce wasteful subsidies and erroneous payments. We will cut spending on prescription drugs by using Medicare’s purchasing power to drive greater efficiency and speed generic brands of medicine onto the market. We will work with governors of both parties to demand more efficiency and accountability from Medicaid. We will change the way we pay for health care — not by procedure or the number of days spent in a hospital, but with new incentives for doctors and hospitals to prevent injuries and improve results. And we will slow the growth of Medicare costs by strengthening an independent commission of doctors, nurses, medical experts and consumers who will look at all the evidence and recommend the best ways to reduce unnecessary spending while protecting access to the services seniors need.”

2. “But let me be absolutely clear: I will preserve these health care programs as a promise we make to each other in this society. I will not allow Medicare to become a voucher program that leaves seniors at the mercy of the insurance industry, with a shrinking benefit to pay for rising costs. I will not tell families with children who have disabilities that they have to fend for themselves. We will reform these programs, but we will not abandon the fundamental commitment this country has kept for generations.”

But don’t take my word for it. Watch this week’s video:

Bruce Greenstein, Secretary of the State Department of Health and Hospitals, has confirmed this decision, and said that with it, Lousiana has become the second state to so decide.

The exchanges are insurance markets meant to allow consumers to choose a subsidized private insurance plan from a range of coverage options and levels. The deadline to have them all up and running, whether they’re run by the states or by the feds, is 2014.

Greenstein believes that federal officials haven’t provided enough detail about how the exchanges should be run. He also said he thinks insurance premiums will go up under the new system, and if that happens he doesn’t want the state government to take the blame.

Further data from the study showed that 25 percent of people who lost their employer-sponsored health insurance were able to find other coverage, while 14 percent paid COBRA premiums to keep their job-based coverage. For many others, however, 16 million out of an estimated 26 million adults who tried to buy health insurance on the individual insurance market in the last three years found it difficult or impossible to find coverage they could afford, and 9 million said they were either turned down or charged more because of an existing health problem, or had a pre-existing condition excluded from their new policy.

The data gets worse. According to the survey 52 million American adults had no health coverage at some point in 2010 while the number of uninsured adults was only 38 million in 2001. The most likely people to be uninsured were adults in families with low-to-moderate incomes (under $44,100/year for a family of four) with 54 percent of lower income adults and 41 percent of moderate income adults being uninsured, while only 13 percent of adults with higher incomes lacked insurance coverage.

Further information from the survey says that 73 million people were either paying off medical debt or were having trouble paying medical bills, while 25 percent of adults with chronic conditions either skipped regular medications, or skipped filling a prescription.

Sara Collins, the author of the study and vice president of the Commonwealth Fund, explained, “The survey shows that over the last decade, increasing numbers of people across the income spectrum went without health insurance, avoided timely health care because it was too expensive, and struggled with medical debt. Millions of working families reported making difficult trade-offs between paying off their medical debt, buying other life necessities, and saving for the future.”

Collins also said that last year’s federal health care reform laws will, “…ensure that families will have the financial means to get the health care that they need, both in good economic times and bad.”

Well, unless the Republicans in Congress don’t kill it.

According to a letter from the U.S. Department of Health and Human Services, it is waiving the requirement that insurance companies must spend a minimum of 80 cents of every premium dollar on medical care and quality improvement. Maine is being allowed to maintain it’s current standard of a minimum of 65 cents of every dollar, though HHS has stated that it will review the figures in two years, and could revoke the waiver at that point.

This decision has made Maine the first state to receive a waiver of this requirement. Requests from Kentucky, Nevada, and New Hampshire are currently pending.

Maine Insurance Superintendent Mila Kofman said the waiver was requested out of the fear that one of the three major insurers in the state would withdraw from the market completely. That insurer, MEGA Life and Health Insurance Co, currently holds 37% of the state’s individual health insurance policies.

President Obama said he supports the repeal.

Under current law, 1099′s must be filed for expenses paid to unincorporated entity, but the new requirement would require that expenses like phone and Internet services be filed starting next year.

According to Jimi Grande, senior vice president of federal and political affairs at NAMIC (the National Association of Mutual Insurance Companies), “This requirement provides no benefit to the businesses that have to file the paperwork or the taxpayers. Instead, it will be a massive drain on time and resources that would be better spent elsewhere.”

The bill was introduced by Rep. Dan Lungren (R – CA), and has 272 co-sponsors. It has since been sent to the House floor for debate and a vote.