Georgia Insurance Commissioner Balks at Request on New Health Law

ATLANTA — The insurance commissioner of Georgia has chosen not to comply with a federal request to create a state pool for high-risk insurance plans, opening a new front in the resistance by state Republican officials to the new federal health care law.

The commissioner, John W. Oxendine, who is a Republican candidate for governor, appears to be one of the first politicians in the country to take that stance. His decision will not affect the cost of insurance for any patients, but it means that the federal government, not the state, will oversee the distribution of certain federal health care funds in Georgia.

Nineteen state attorneys general — nearly all Republicans — are filing lawsuits challenging the constitutionality of the health care law. The issue has been especially contentious in Georgia. After the state attorney general, a Democrat, called the lawsuits a waste of taxpayer money, Republican lawmakers here drafted a petition calling for his impeachment, and the Republican governor appointed a “special attorney general,” a private lawyer, specifically to file a lawsuit on the state’s behalf.

Mr. Oxendine, in a letter Monday to Kathleen Sebelius, the secretary of health and human services, said he could not allow Georgia to join “a scheme which I believe the Supreme Court will hold to be unconstitutional, leads to the further expansion of the federal government, undermines the financial security of our nation, and potentially commits the State of Georgia to future financial obligations.”

In an interview, Mr. Oxendine said he had spoken to at least two governors and one insurance commissioner from other states who were considering taking the same stance, although he would not say which states.

This month, Ms. Sebelius had asked the governors and elected insurance commissioners of every state to decide by April 30 whether, and how, to create the insurance pools. Under the health care law, a total of $5 billion in federal money will be allocated to reduce the costs of insurance premiums for high-risk patients by the end of 2013.

A spokesman for Ms. Sebelius, Nicholas Papas, said the decision by Mr. Oxendine would not affect the premiums that any Georgians pay.

“For too long, Georgians with pre-existing conditions have been locked out of the insurance market,” Mr. Papas said in a statement. “If state officials in Georgia elect not to participate in the high-risk pool program, our department will work to ensure Georgians with pre-existing conditions have access to affordable insurance through the federal high-risk pool program that we will establish this year.”

Mr. Oxendine said his opposition to the pool program was legal and financial, not politically motivated. But some political experts noted that any stance against the federal health care law could help him in the crowded Republican primary race for governor in July.

“I suspect the decision was heavily influenced by politics,” said Charles Bullock, a professor of political science at the University of Georgia. “The electorate here is hostile to Barack Obama and health care reform.”

Mr. Oxendine’s decision is not necessarily the final word on whether Georgia will create the insurance pool. Bert Brantley, a spokesman for Gov. Sonny Perdue, said the governor’s office would also issue a response to Ms. Sebelius, but agreed with Mr. Oxendine’s arguments against the pool.