Congressional Republicans are making no secret of their goal of rolling back health care reform, but the first tests facing the Obama administration are likely to come from the states.

The law’s mandates have already provoked legal challenges. The next confrontation may arise as requirements for health exchanges and expanded Medicaid coverage are addressed by states that oppose them.

Maine is likely to be one of them. During his election campaign, Governor-elect Paul LePage pledged to kill off Dirigo Health in favor of free-market efforts to expand coverage. LePage also called for repeal of the federal health care reform law.

We hope the LePage team is confronted by public and legislative support for both federal and state health reforms. Public health efforts here have already proved their worth. Maine has improved to become the nation’s 9th healthiest state, according to America’s Health Rankings, and the 6th best in covering the uninsured. Since 2005, Dirigo Health has reduced health care spending and provided coverage to thousands.

The program has struggled to achieve adequate funding, but the new federal law could enable Dirigo to expand its mission as a health insurance exchange. Given the uncertainty about the future of health care coverage, Maine shouldn’t throw away the advantages and expertise it has accumulated.

The alternative advanced by LePage isn’t a good solution. Encouraging Maine residents to purchase insurance in other states is likely to create problems for consumers; a patient who was denied benefits unfairly, for instance, wouldn’t be able to turn to Maine officials for help.

Out-of-state insurers may offer attractive rates to healthy Mainers, but they won’t compete for individuals and companies with a history of medical bills. These consumers will have to continue to purchase coverage from Maine-based companies, who are likely to demand higher rates for taking on a greater share of risk.

Earlier this year, Maine enacted a new law forbidding insurers from setting a lifetime cap on benefits. The Legislature acted after hearing the testimony of a woman who said the bills for her dying husband’s care had reached $1.6 million ”“ far beyond the cap on his policy.

After Jan. 1, 2011, Mainers with health insurance will no longer have to worry about losing their coverage during a serious illness. The question is whether the opponents of health care reform really intend to strip their constituents of such hard-won protections.

— Questions? Comments? Contact Managing Editor Nick Cowenhoven at nickc@journaltribune.com.