State government officials should not step in and block portions of the health care reform law that they disagree with. The law was intentionally designed to empower state and local authorities; they have the power to adapt and transform the law according to their unique market needs. If governors and their appointees refuse to implement the law, then the millions of Americans who have been waiting for solutions for their health care to improve will need to exercise their democratic ability to influence the process.

Republican officials and appointees are advised to work with patients, clinicians, payors and policy experts to help shape rules and regulations that will benefit their local conditions. While “repeal” and “block reform” make strong campaign slogans, the law is likely to and should remain intact. Refusing federal dollars and ignoring requests for public comment will only disadvantage constituencies and local health care marketplaces. While the health reform law is not perfect, it is still the law. Moving forward, we know that the bill will be tweaked and fine-tuned, and it is in the best interest of all elected officials to take a seat at the table and participate, not walk away.