HHS official touts Medicaid, mum on Walker choice

"This is not right. This is not a good plan," Peterson said Monday. "This plan is grounded in political ambition because it makes no sense from a practical, moral or fiscal sense."

Munson said it's understandable that the changes taking place under President Barack Obama's health care law, like establishing the private marketplaces and expanding Medicaid, would result in lawsuits and states diverging in what approaches to take.

"When you have this big of a societal change, it's not surprising we have these kind of struggles and fights," said Munson, who served three times as deputy secretary of the Wisconsin Department of Health Services, most recently in 2010 and 2011.

Wisconsin is one of 26 states that have deferred to the federal government to set up their health insurance exchanges, the online marketplace for consumers to buy government-subsidized private insurance. Twenty-three states plus the District of Columbia said they would run their own exchanges or partner with the federal government. Utah's status is unclear.

The new exchanges are scheduled to go into operation in October, with insurance coverage beginning in January 2014. They are a key part of the Affordable Care Act, the health care law championed by Obama that is reshaping how Americans buy insurance.

Munson said 27 states have chosen to expand Medicaid as allowed under the law, a move he said will help save lives and provide needed preventative care. States that had been against the health care overhaul law — including Michigan, Arizona and Florida — are now recognizing that expanding Medicaid as allowed under the law is the best approach, he said.