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Democratic and Republican states are moving in opposite directions on health policy, leaving Americans with starkly divergent options for care depending on where they live. The Trump administration and congressional Republicans, by easing many of the Affordable Care Act’s nationwide requirements after failing last year to repeal the entire law, are effectively turning major components of health policy over to the states. The roughly half of states controlled by Republicans are therefore moving aggressively to roll back the law widely known as Obamacare, while the smaller number of Democratic states are working to bolster it. As a result, the health-care options in any given state are likely to depend on which party controls the statehouse. (Armour, 2/28)

Little by little, the Trump administration is dismantling elements of the Affordable Care Act and creating a health care system that looks more like the one that preceded it. But some states don’t want to go back and are working to build it back up. Congress and the Trump administration have reduced Obamacare outreach, weakened benefit requirements, repealed the unpopular individual insurance mandate and broadened opportunities for insurers to offer inexpensive but skimpy plans to more customers. (Margot Sanger-Katz, 2/28)

The latest lawsuit against Obamacare poses little immediate danger to the health care law — but it could look a lot more potent if the balance of the Supreme Court changes in the next two years. The case may look like a long shot, given that the courts have upheld the health law more than once. But proponents of Obamacare have notoriously underestimated the stream of legal challenges against the Affordable Care Act, and the staying power of the conservatives intent on scrapping the 2010 law. (Haberkorn, 2/27)

One day after 20 states including Wisconsin sued to eliminate the Affordable Care Act, GOP Gov. Scott Walker visited two hospitals to hold ceremonial signings of a measure to spur a 1332 waiver application to stabilize the state's individual market.It's a tale of of two tactical plans. While Wisconsin and other Republican-majority states have to work the political arena and appeal to conservatives to shore up their exchanges, they're also using the courts to dismantle the law. (Luthi, 2/27)

Idaho’s rebellion began in early January with executive order No. 2018-02. The directive from Gov. C.L. “Butch” Otter told his state insurance department to allow “creative options” in health coverage, unfettered from “the overreaching, intrusive nature of Obamacare and its infringement on Idahoans’ freedoms.” Within a matter of weeks, the department decreed that insurance companies have substantial wiggle room as long as they offer at least one health plan that meets the Affordable Care Act’s rules. They can sell policies that lack maternity care and charge older residents more than permitted under the 2010 law. They can impose yearly coverage limits and block coverage of customers’ prior medical conditions. (Goldstein, 2/27)

An Idaho official says Trump administration officials did not give him an indication on whether they are going to block his state’s controversial move to get around ObamaCare rules after a meeting Saturday. Idaho insurance commissioner Dean Cameron and Gov. Butch Otter (R) met with Health and Human Services (HHS) Secretary Alex Azar to discuss the state’s plan. Democrats are pressing Azar to step in and enforce ObamaCare's rules, saying that Idaho’s move is plainly illegal. (Sullivan, 2/27)

Kaiser Health News: Ding Dong! The Obamacare Tax Penalty Is(n’t) Dead

Rick, Patrick and Michael recently commented on Covered California’s Facebook page, urging others to ditch health insurance because: “No more fines or penalties!!! Trump took care of that!! Saved me 700 bucks this year!!!” “Trump removed the penalty for not having insurance.” “I’m pretty sure Trump abolished the illegal penalty.” They’re right — and wrong. (Bazar, 2/28)

Gov. Scott Walker signed a $200 million bill Tuesday to stabilize Obamacare markets in Wisconsin even as state Attorney General Brad Schimel sued seeking to block the entire law. The GOP governor — a longtime critic of the Affordable Care Act — has emphasized in recent weeks that he wants to hold down prices for insurance purchased through the law and make sure it's affordable for state residents. (Stein, 2/27)

Missouri and Kansas have joined 18 other states in seeking to have the Affordable Care Act declared unconstitutional following Congress’ repeal last year of the tax penalty associated with the individual mandate. In a lawsuit filed late Monday in federal court in Texas, the coalition of 20 mostly red states claimed that the elimination of the tax penalty for those who don’t buy health insurance renders the entire healthcare law unconstitutional. (Margolies, 2/27)