Perhaps some state lawmakers were waiting for the U.S. Supreme Court to rule on whether or not key provisions of the Patient Protection and Affordable Care Act were constitutional.
Other state lawmakers, no doubt, were waiting to see who won the November presidential election.
And, of course, many state lawmakers view the PPACA as an egregious federal intrusion on state sovereignty that should be derailed or delayed at every opportunity.
Whatever the reasons, a report released this Thursday by The Commonwealth Fund shows that only 11 states and the District of Columbia have passed laws or issued regulations to implement the PPACA's health insurance market reforms that go into effect in just 11 months.
Thirty-nine states have taken no action. The Commonwealth Fund says that could limit those states' enforcement of the reforms, which include bans on preexisting conditions, a minimum benefit standard, and limits on out-of-pocket costs.
"These are incredibly important market reforms that guarantee that people have access to health insurance coverage starting in January," Sara R. Collins, vice president, Affordable Health Insurance, at The Commonwealth Fund, told HealthLeaders Media.