November 7, 2012 – President Barack Obama’s re-election ensures the survival of his landmark health care law, but predominantly Republican state officials will get a big say in how it is carried out. State lawmakers will control whether millions of uninsured people get coverage through Medicaid beginning in 2014, as the law envisions. They’ll also decide whether to set up online markets where individuals can shop for coverage and seek federal subsidies to lower their costs. Next year, 30 states will be led by Republican governors, and 24 will have Republican-controlled legislatures. Most of those had challenged the law in the Supreme Court. Still, analysts believe the president’s victory will prod those, as well as several reluctant Democratic-led states, to move forward. “Red states and undecided states [will] reconsider what they have been saying and doing the past few months,” said John Poelman, senior director of Leavitt Partners, a consulting firm advising states on carrying out the law, citing pressure from consumers, hospitals and other providers to expand coverage. States have considerable sway over how the law is carried out because the Supreme Court gave them the power to reject the expansion of Medicaid, which had been expected to cover more than half of the 30 million people gaining health insurance under the law. Since the court’s decision, six Republican governors in Texas, Florida, Mississippi, South Carolina, Louisiana and Georgia have said they will not participate, even though the federal government would cover the costs of new enrollees through 2016 and at least 90 percent thereafter.