Love it or hate it, but don't believe that "Obamacare" hasn't set in motion a national argument regarding national health insurance delivery. Virtually every person, and his health provider, will eventually feel the impact of what transpired this past year. Some of that impact will be produced by changes in state health insurance laws. Health insurance reform is praised by liberals and eyed with suspicion by conservatives. How much of it is put into play depends on largely getting the two camps closer to some agreement.

One state, Kansas, has produced a plan to slice $350 million from the state's Medicare costs over the next five years. It's also anticipated that the plan will save the federal government about $500 million during the same time frame. The Kansas plan can't be implemented until Washington okays a waiver of Medicaid's requirements. That okay isn't expected for another year. Other states have expressed interest in how the Kansas plan would work. The idea developed by Kansas Gov. Sam Brownback is a compilation of Medicaid practices used in several states.

Many state Medicaid directors want the federal government to speed the program's efficiency by putting health provider aid over bureaucratic infringement. One state-influenced improvement has been the creation of the Medicare and Medicaid Federal Coordinated Care Office. This office works with states who qualify for both programs in an effort to better aid seniors and adults with disabilities. The Affordable Care Act is designed to quickly deliver new workable ideas with other states. It prioritizes state requests for permission to examine how other state health insurance systems evolved and how they worked. Until now, such information routinely took more than a year and was handed from one bureaucratic level to another before reaching the requesting state.

One of the most contentious issues getting a fresh perspective centers on cross-state reciprocity agreements. Eliminating the existing ban on free-market movement of health insurance could create a consumer base that far exceeds today's total. The hope is that such a large number of potential clients would influence insurance companies to introduce affordable health insurance policies into their business areas. Georgia is a leading state in this effort. Pending legislation would direct the Georgia Insurance Commissioner to lead a multi-state coalition that thrives on cross-state insurance sales.

A key element of Obamacare is the Affordable Care Act. While more than half the states are challenging the law, and some refuse to implement it, others are looking for ways to expand its parameters. Vermont, for instance, is working to develop a single-payer system. The state has talked with Washington about waivers needed to develop a single-payer plan.