MADISON, Wis. -- Regardless of the outcome of the U.S. Supreme Court's ruling on President Barack Obama's health care overhaul law, Wisconsin Gov. Scott Walker has vowed not to do anything until after the November election.
Walker, an outspoken critic of the law, originally said in January that he would not begin setting up the state's health insurance exchange required by the law until after the court ruled. Earlier this month, the Republican governor went even further, saying that if the law is upheld he will not do anything until after the election, hoping that the next president and Congress will repeal it.
Only after those two fail would Wisconsin "figure out some alternative within the state," Walker said in a statement released by his office this week.
Republican state lawmakers appear to be on board with that approach, even while Democrats and health care advocates say the state should be more bullish in moving forward with consumer protections and other reforms under the law.
The law would provide health care to about 30 million uninsured people and make coverage more affordable to millions of others by expanding the reach of Medicaid, forbid insurance companies from refusing coverage to people with pre-existing illnesses and creating new subsidies. Officially known as the Patient Protection and Affordable Care Act, the law is called "Obamacare" by opponents, including Walker.
The Supreme Court, expected to rule on the law Thursday, could allow it to remain or strike down all or part of it. But the ruling is likely to signal only the next stage of the debate, not settle the issue, especially in states such as Wisconsin where Republicans control the governor's office and legislature.
Walker's decision to wait until after the November election before doing anything makes sense, said state Assembly Health Committee Chairman Rep. Jeff Stone, R-Greendale.
"There's no way we're going to do anything between now and the elections anyway on this topic," Stone said. "We owe it to business in this state, and our own economy, to have some clear direction."
One of Walker's first actions on the day he took office in January 2011 was to authorize Republican Attorney General J.B. Van Hollen to join the multistate lawsuit trying to block the law, which Congress passed in 2010.
"He's on the far end of the spectrum in terms of trying to block the law and doing nothing to prepare for it," said Robert Kraig, executive director of Citizen Action of Wisconsin, a health care advocacy group that supports the law and expanding health insurance coverage.
Even if the court does as many predict and strikes down the mandate that everyone have health insurance, Kraig said other important changes, including the expansion of Medicaid and allowing young adults up to age 26 to remain on their parents plans, could remain.
"Wisconsin needs to be in position to take full advantage of this law," he said.
State Rep. Jon Richards, the ranking Democrat on the Assembly Health Committee, said it's a big mistake not for Wisconsin to move forward with implementing the health insurance exchange and other parts of the federal law.
"Wisconsin should be in charge of our own destiny with health care and the consumers in Wisconsin should get the benefits of the law no matter what happens in Washington," Richards said.
Wisconsin, like many states, has done nothing to set up a health insurance exchange through which residents could choose among different plans to buy private insurance with taxpayer-provided assistance to cover the cost of premiums. The exchanges are designed to increase competition by requiring insurers to offer more plans and provide more information.
The U.S. Department of Health and Human Services has set a Nov. 16 deadline for states to submit plans for their health insurance exchanges, which must be in place by 2014. The federal government would step in and run exchanges in states that don't have them.
Richards and Democratic state Sen. Jon Erpenbach introduced a bill last year, supported by a host of consumer advocacy groups, that would have put major parts of the federal overhaul into state law, including the ban on denying coverage due to a pre-existing condition and removing annual and lifetime benefit caps.
The proposal went nowhere in the Republican-controlled Legislature.
Richards said it's frustrating that the Walker administration has been blocking the changes and "frittered away" the opportunity to be proactive.
"It's about political posturing," Richards said.
Wisconsin has relatively few people without insurance coverage, thanks its popular BadgerCare programs that began under welfare reforms enacted by Republican Gov. Tommy Thompson in the late 1990s. The programs were expanded under Democratic Gov. Jim Doyle, but Walker scaled them back amid skyrocketing demand and state budget troubles.
Based on 2010 U.S. Census Bureau data, 90.6 percent people in Wisconsin had insurance coverage. That tied with Maine for the third-highest rate of any state, after Hawaii at 92.3 percent and Massachusetts at 94.4 percent.
A spokeswoman for Walker's Department of Health Services emphasized that Wisconsin was able to reach a high level of coverage without a federal mandate.