A federal court blocked Missouri from using a state law to interfere with the Affordable Care Act. This important decision deals a blow to the efforts of some state governments to use state law to obstruct implementation of comprehensive, nationwide health care reform.

Under the Affordable Care Act, health insurance exchanges have become operational in every state. Each state may decide to operate its own exchange or to let the federal government operate one for it. Missouri, like Pennsylvania, has opted for the federal government to operate its exchange. In states with federally run exchanges, the federal government oversees application assistance programs, in which “Navigators” and “Certified Application Counselors” work to help individuals compare health plans and complete the enrollment process.

Missouri’s law would have forbidden Navigators and Certified Application Counselors to perform certain types of work, and it would have forced them to meet burdensome licensing requirements. A similar bill (the link below) in Pennsylvania has passed two committees in the House but has been tabled since September 2013. The decision held that “any attempt by Missouri to regulate the conduct of those working on behalf of the [federally facilitated exchange] is preempted. . . . Having made the choice to leave the operation of the exchange to the federal government, Missouri cannot choose to impose additional requirements or limitations on the exchange.”

The court further asserted that Missouri’s licensing requirements for Navigators and Certified Application Counselors “frustrate[d] the federal purpose” of the Affordable Care Act.

This decision comes in the context of numerous states’ program of massive resistance to the Affordable Care Act. States with administrations hostile to the Act , including Pennsylvania, have enacted statutes, filed lawsuits and turned down federal money all in an effort to block full implementation of the Act and to forestall what they perceive as a calamity— a societal expectation that all Americans will have access to health care. By disarming one of the more potent weapons in such states’ arsenals, the Missouri decision will help the Affordable Care Act to achieve full implementation nationwide.

Click here to read the full decision.