Health Care Nullification Bills Fail Across Country: Implementation Moving

Health Care Nullification Bills Fail Across Country: Implementation Moving

Thursday, April 15, 2010



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Health Care Nullification Bills Fail Across Country: Implementation Moving

Progressive States Network has a new analysis of the progress of state health care legislation which indicates the failure of conservative attempts to obstruct reform at the state level.  This resource, located at, will be updated as more sessions end.  Many more nullification bills are expected to fail this session, as state leaders and legislators across the country defeat the right-wing agenda attacking health care reform.

The key results so far:

  • 40 - Number of states claimed by the American Legislative Exchange Council (ALEC) to have "defended health care choice" through the actual or proposed introduction of health care nullification bills intended to "oppose Obamacare"
  • 4   - Number of states where health care nullification bills have actually passed
  • 14 and counting... - Number of states where health care nullification bills or constitutional amendments have failed

In recent months, the health insurance industry-funded ALEC has claimed that over 40 individual state legislatures have "defend[ed] health care choice" by being witnesses to the proposed or actual introduction of their model legislation in an attempt to nullify the recently passed federal reforms in the Patient Protection and Affordable Care Act.

Despite their model legislation's patent unconstitutionality, ALEC has persisted in pushing nullification bills in state capitals across the nation, promising those who want to obstruct reform that they will "protect citizens from ObamaCare" and "stop ObamaCare at the state line."

In fact, nullification bills have already been rejected or failed to pass in at least fourteen states where ALEC claimed legislators would defy federal law.  ALEC style bills or proposed constitutional amendments have failed in Arkansas, Colorado, Delaware, Indiana, Iowa, Kansas, Maryland, Michigan, Mississippi, New Hampshire, New Mexico, North Dakota, South Dakota, West Virginia and Wyoming.

In other states where ALEC has claimed success, such as Montana, Rhode Island, and Texas, health care nullification bills have yet to even be introduced.  Nullification proposals have met significant opposition in states around the country; a few examples among these states:

  • In Iowa, the 2010 session ended with the House minority leader conceding the failure of conservative efforts to nullify federal health care reform.
  • In Arkansas, the 2010 session ended without action on a non-binding bill intended to "prevent involuntary enrollments in health care insurance programs."
  • In Delaware, legislative leaders directed a nullification effort to a committee described in a recent news report as a "favored burial ground for bills."
  • In North Dakota, a proposed constitutional amendment failed in 2009.
  • In Maryland and Michigan, attempts at nullification through constitutional amendments failed in committee

Notably, in Maine, where a nullification bill was not introduced, legislative leaders defeated a resolution promoted by conservatives calling on the Attorney General to join a lawsuit seeking to block the implementation of federal reform.

States Moving Forward on Implementation: While the right wing is focused on grandstanding and political gamesmanship, legislators and officials in all 50 states are moving forward with the hard work of planning the effective implementation of the Patient Protection and Affordable Care Act at the state level. Many of these efforts began well before the passing and signing of federal reform, and will accelerate in the coming weeks and months as responsible leaders in the states focus on delivering quality, affordable healthcare to their constituents.

Here are just a few of the efforts publicly announced, although others are moving forward in states across the country (updated 4/13/10).  For more details on implementation, see

See our extended resources below, as well as resources opposing health care nullification efforts and supporting implementation in the states.

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Tax Day: With Middle Income Families Paying Less Federal Taxes, States Have More Leeway for Revenue Increases

As states struggle to close budget gaps, it's worth highlighting that due to tax changes at the federal level, most middle income families are paying a far smaller percentage of their income in federal taxes than they did a few years ago.  So while states should concentrate revenue increases on those who can most afford it, there is greater capacity among middle income families to absorb some tax increases due to the lower federal tax burden.

Two new studies highlight this reality. In a recent policy brief, President Obama cut taxes for 98% of working families in 2009, Citizens for Tax Justice found , detailing that provisions in last year's Recovery Act reduced federal income taxes for 98 percent of all working families and individuals.  More broadly, the Center on Budget and Policy Priorities (CBPP) outlines in their report, Federal Income Taxes on Middle-Income Families at Historically Low Levels, that a family of four in the exact middle of the income spectrum will pay only 4.6 percent of its income in federal income taxes this year, the second-lowest percentage in the past 50 years.

Despite the the alarms advanced by the Tax Foundation and other conservative groups that average Americans have to work for many months to pay their tax obligations, a separate report from CBPP debunks these claims.  Congressional Budget Office data shows that 80 percent of U.S. households pay federal tax at a lower rate than the Tax Foundation’s estimated “average” federal tax obligation.

More Options for States to Raise Revenue:  With a lower federal tax burden, generating revenue at the state level become a less onerous proposition.  Progressive States Network has highlighted many of the best practices for states to raise revenue for needed services in an earlier Stateside Dispatch, Revenue Options in 2010: Making the Case and Debunking the Myths, which details how states are raising rates on high-income individuals, closing corporate loopholes, and expanding the sales tax base to services to increase revenue and fairness.

Emphasizing the argument for greater taxes on the wealthiest families, a new Economic Policy Institute report, At the Top: Soaring Incomes, Falling Tax Rates, shows how the 400 American families with the highest incomes have seen a dramatic decline in their effective tax rate since 1992.

Another report, Leaving Money on the Table, from the Institute on Taxation and Economic Policy and United for a Fair Economy's Tax Fairness Organizing Collaborative, demonstrates that residents in states that predominantly rely on regressive sales tax rather than a progressive state income tax, pay much higher federal income taxes.  States flagged in the analysis include Florida, Nevada, South Dakota, Tennessee, Texas, Washington and Wyoming.  They conclude that states who "are most flagrantly ignoring the benefits of this important source of tax fairness could use this revenue-sharing agreement to provide valuable tax cuts to many state residents without depleting state coffers by a dime."

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Critics Resisting New Jersey Governor's Push for Further Privatization

Last month, New Jersey Gov. Chris Christie unveiled his $29.3 billion FY2011 budget proposal -- an extremely regressive plan that would only exacerbate the economic pain for the state's working and middle class families.  The Governor's budget relies on severe reductions to municipal and county aid, discontinuing property tax rebates, completely eliminating funding for grants to support clinical family planning services, cutting aid to school districts, letting an income tax surcharge on high-end earners expire, closing psychiatric hospitals, proposing a constitutional amendment to lower the the property tax cap to 2.5 percent that may be placed on the November ballot, and reducing the state workforce by over 1,300 workers.  As state Sen. Stephen Sweeney concisely stated, "The wealthy people in New Jersey got a tax cut.  The middle class and the poor are going to get a tax increase.  It’s that simple."

Push to Privatize:  One of the more troubling aspects of the budget is the broad effort to privatize state services.  In early April, Gov. Christie established a privatization panel by Executive Order, seeking to identify $50 million in savings.  The state’s troubled history with privatization is well-documented.  In a recent hearing on the issue, the Executive Director of the state’s Commission of Investigation, Alan Rockof, cited the Motor Vehicles Commission distributing contracts to politically connected vendors in the 1980s, millions of dollars wasted on contractors for vehicle inspections, and the imprudent implementation of the E-Z Pass toll system that was fraught with high cost and delays due to private contractors.  He commented, “[i]f one common theme runs through all these disturbing case studies, it’s this: waste and abuse of the public treasury and public property can flourish if no one is minding the store on the public’s behalf.”

It is quite telling that the Governor's push coincides with the release of a report revealing the dangers of privatization.  SEIU Local 32BJ commissioned the Clarion Group to analyze contracts and financial data of 10 school districts that outsource their food services to two companies, Chartwells and Sodexo.  In the report, Hard to Swallow: Do Private Food Service Contractors Shortchange New Jersey Schools?, the group found that the corporations overcharged the 10 districts by $320,000 and "if the approximately 378 New Jersey school districts using FSMCs (food service management companies) are also being overcharged at the same rate, the total amount of taxpayer money being misappropriated would come to $12 million, or enough to pay the annual salaries of 186 New Jersey teachers."

These troubling numbers mirror the general pitfalls of privatization.  As PSN has noted previously, the policy often leads to the the loss of public control, lack of oversight and transparency, inability to establish standards, policy driven by profit rather than actual public need, endangerment of vulnerable populations, increased costs, eventual loss of public revenue, and inferior and unreliable service provision.  Dealing with the aftermath of the greatest economic downturn since the Great Depression, states can ill-afford to pursue costly, inefficient, and potentially damaging privatization schemes.

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Youth Registration Law Approved in Maryland

With a vote on the final day of the Maryland legislative session and an expected governor's signature, Maryland will become the fifth state with 16-year-old youth voter pre-registration.  The bill, HB 217, is expected to create thousands of new voters and encourage participation among young people.

"This is a big victory for democracy," said its sponsor, Senator Jamie Raskin, "With this legislation, we can now register young people before they graduate and are off into the work force or to college or the military.  All the studies show that, when people register, they vote." 

Other states with 16-year-old pre-registration include Hawaii, Florida, North Carolina and Rhode Island.

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Research Roundup

Jobs at Risk for Vulnerable Populations

  • The Kids Aren’t Alright — A Labor Market Analysis of Young Workers - While the national unemployment rate has yet to meet the dismal 10.8% benchmark set in 1982, workers age 16-24 have reached a post-war unemployment highs with an unemployment rate peaking at 19.2%, according to this analysis by the Economic Policy Institute.  Though young adults represent only 13.5% of the workforce, they now account for 26.4% of unemployed workers, a dangerous development with so many young people losing out on the chance for the early employment shapes long-term employment possibilities.
  • Extending the TANF Emergency Fund Would Create and Preserve Jobs Quickly and Efficiently - The TANF Emergency Fund, which was created by Recovery Act, has allowed states to create subsidized job programs for TANF recipients and other low-income unemployed individuals, as detailed in this Center on Budget and Policy Priorities report.  With the Fund set to expire on September 30, these key programs in many states are set to be scaled back, highlighting the importance of the federal government renewing the program.

Demanding Greater Transparency and Accountability in Spending and Contracting

  • Following the Money: How the 40 States Rate in Providing Online Access to Government Spending Data - US PIRG analyzes and ranks each state on their development of comprehensive, one-stop, one-click budget accountability and accessibility.  The authors note, “[i]n the past five years, states across the nation have made significant progress in budget reporting and accountability,” though there is substantial room for improvement.  They further the point by explaining the major benefits of corporate transparency, which “can be used by citizens and government officials to identify inefficiencies, promote best practices, check corruption, and help to avoid another financial crisis.  Providing cutting-edge checkbook-level transparency will also help to restore the trust in government that has been compromised during the budget crisis.”
  • Audit the Tax Code: Doing What Works for Tax Expenditures - Arguing that spending programs delivered through tax breaks should have the same scrutiny as direct spending programs, this Center for American Progress report argues that tax expenditures should be integrated directly into the budget process with far greater transparency and accountability.
  • Little Evidence Exists to Show Private Prisons are Cheaper or Better - The Florida Center for Fiscal and Economic Policy finds little evidence to support the claim that privatizing prisons leads to cost savings or increased efficiency.  The authors conclude that more accountability and a reformed procurement process would benefit the state.
  • provides a new way to track the influence of political donors in state and federal campaigns.  The public will be able to search through data about political donors, lobbyists, and lawmakers, and download nuggets of interest or whole sets of data that may illuminate policy discussions and legislative votes.  The Sunlight Foundation collaborated with the National Institute on Money in State Politics, the Center for Responsive Politics, and others to create

Close the Hidden Funding Gaps in Our Schools - This new report from The Education Trust examines how inadequate allocation of federal funds by school districts across the nation is having a negative impact on schools in high-poverty areas.  Examining per-student expenditures in New York City, it reveals major differences between spending in high-poverty and low-poverty schools, with schools with less experienced teachers in high-poverty areas receiving less money than schools in affluent areas.

Just Pay: Improving Wage and Hour Enforcement at the United States Department of Labor - Serving as a useful guideline for state enforcement efforts, the National Employment Law Project  for the Just Pay Working Group offers a set of concrete recommendations to the US Department of Labor's Wage and Hour Division on how to improve enforcement of  the nation's wage and labor laws.  The report comes at a time of great hope for improved collaboration by the federal government with the states on cracking down on wage theft against employees around the country, bolstered by more labor investigators and a renewed commitment from US Secretary of Labor, Hilda Solis, to enforce employment law and crack down on employers who violate their workers' rights.  The report urges government enforcement officials to target industries with high numbers of violations, address worker misclassification, enhance the agency's ability to respond to workers' complaints, and optimize its outreach to workers vulnerable to exploitation - including undocumented immigrants.  

Please email us leads on good research at


Health Care Nullification Bills Fail Across Country: Implementation Moving

Opposing Health Care Nullification Efforts:

Health Care Implementation in the States:

Tax Day: With Middle Income Families Paying Less Federal Taxes, States Have More Leeway for Revenue Increases

Progressive States Network - Revenue Options in 2010: Making the Case and Debunking the Myths
Citizens for Tax Justice  - President Obama Cut Taxes for 98% of Working Families in 2009
Center on Budget and Policy Priorities - Federal Income Taxes on Middle-Income Families at Historically Low Levels
Institute on Taxation and Economic Policy and Tax Fairness Organizing Collaborative - Leaving Money on the Table
Economic Policy Institute - At the Top: Soaring Incomes, Falling Tax Rates

Critics Resisting New Jersey Governor's Push for Further Privatization

Clarion Group — Hard to Swallow: Do Private Food Service Contractors Shortchange New Jersey Schools?
New Jersey Office of Management and Budget - FY2010-2011
Progressive States Network - Privatization During an Economic Downturn: Still Inefficient and Problematic

Youth Registration Law Approved in Maryland

Progressive States Network -  Expand Youth Voting
FairVote - Testimony on HB 217
Fair Vote - Youth Voter Pre-registration Fact Sheet


The Stateside Dispatch is written and edited by:

Nathan Newman, Executive Director
Nora Ranney, Legislative Director
Marisol Thomer, Outreach Director
Fabiola Carrion, Broadband & Green Jobs Policy Specialist
Enzo Pastore, Health Care Policy Specialist
Suman Raghunathan, Immigrant Rights Policy Specialist
Altaf Rahamatulla, Tax & Budget Policy Specialist
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