The Patient Protection and Affordable Care Act (PPACA), which promises to expand health insurance coverage to millions of Americans, is currently stalled in the New York State Senate because of Republican opposition in the Senate majority to setting up a health care “exchange” in the state, as required by the federal law. New York could stand to lose tens of millions of dollars in federal funding if the state government does not begin taking steps to enact the exchange by June 2012.

The PPACA, the signature health care reform legislation advocated by President Barack Obama and passed by Congress in 2010, mandates that most Americans not covered by Medicare or Medicaid purchase health insurance by Jan. 1, 2014. The law stipulates that states set up online marketplaces, or “exchanges,” where individuals and small business owners can compare and purchase insurance policies. Fifteen states have done so already, although Massachusetts and Utah had such insurance exchanges in place before Congress passed the PPACA.

New York, which has about 2.6 million uninsured residents, could lose as much as $100 million in federal grants if it does not establish an exchange system, according to a New York state government website that provides details about health care reform. New York has already received about $39 million in federal starter grants to begin planning a state health exchange program, but the state will not be eligible to receive further “Level 2” grants until it has set up a fleshed-out rubric for operating the exchange. States may apply for Level 2 grants at the end of each financial quarter through June 2012. The deadline for the most recent quarter application period passed on Sept. 30.

The Democratic majority leadership in the New York State Assembly, the Republican majority leadership in the Senate and Gov. Andrew Cuomo brokered an agreement to set up a state health care exchange in June this year, but the Senate Republicans pulled the legislation right before the last Senate session adjourned at the end of June. The Assembly passed its version of the bill.

Many Republicans around the country remain opposed to the implementation of the PPACA. They argue that the federal health care law violates individuals’ and states’ constitutional rights in requiring citizens to obtain health insurance and states to set up exchanges. The U.S. Supreme Court is expected to hear a case this term challenging the PPACA’s constitutionality.

John McNulty, an assistant professor of political science at Binghamton University, said it is conceivable that the Supreme Court could rule that the PPACA is an overreach of the federal government’s authority under the U.S. Constitution’s Commerce Clause.

“In the past 30 years or so, with the rightward, limited-government shift of the U.S. Supreme Court, the interpretation of the Commerce Clause has been reined in somewhat,” McNulty said. “The health care act is likely going to be a critical case in determining the go-forward interpretation of the Commerce Clause, because it involves a tremendous insertion of federal authority in a positive right.”

As of Tuesday, Sept. 13, the PPACA has extended the period that individuals can be covered by their parents’ health insurance plans. Under the PPACA, individuals are eligible to remain dependents on their parents’ health insurance plans until the age of 26, regardless of their student status.

Many BU students, however, said they were unaware of the status of the PPACA’s enactment in New York.

Justin Pierce, a senior majoring in management, said he finds it difficult to stay informed about news and public policy issues related to health care.

“Keeping up with what goes on in the political world can be a lot of work,” Pierce said. “I haven’t been following the health care issue and it’s not always very clear how the new act would affect me in the following years.”

Emily Schumacher, a sophomore in the Decker School of Nursing, also said she did not know specific details about how the PPACA is supposed to change the U.S. health care system.

“I can’t say that I know about the new health care act in detail,” Schumacher said. “However, I do know that it is reassuring to be able to stay on my parents’ plan until I’m 26, especially with how shaky the economic future is for many of us graduating from college in the next few years.”

Recently, the Census Bureau reported that the number of insured Americans in the 18-to-24 age group has decreased by 2 percent, or about 501,000 people, since 2010.