Feds Moving on Health Care Law, Gov. Scott Not Budging
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Federal regulators charged with implementing the Affordable Care Act stated Monday they are trying to work with states to start up the law’s health care "exchanges" -- exchanges are one-stop consumer markets for buying insurance.
But they said they will install a federal health care exchange if a state refuses to set one up on its own.
The news carries weight for Florida, because Gov. Rick Scott, who first came onto the political scene as a staunch opponent of the federal overhaul of health care signed into law by President Barack Obama last year, is not moving from his stance that state agencies should not begin implementing the law.
The health care exchanges -- scheduled to be in place by January 2014 -- are touted as a more transparent way for individuals to compare health insurance policies’ coverage and prices online, over the phone or in person. They can be set up by the states themselves, done locally or regionally, or operated by a nonprofit, or can be done in partnership with the federal government.
States will be in charge of selecting plans in the exchanges, but they must meet minimum coverage and quality standards set forth by the federal Health and Human Services agency. Those standards are scheduled to be released later this year.
HHS officials said the guidelines for the exchanges give states enough flexibility to adjust the federal exchanges to their unique circumstances, but the final say on what plans qualify will remain in federal hands.
“In terms of setting up an exchange and meeting minimum standards, those would still apply,” said Steve Larsen, HHS director of the Center for Consumer Information and Insurance Oversight.
The proposals and claims of flexibility for states did not thaw Scott’s position on the law, or its implementation.
“As proposals, we are not about to change our policy to start implementing Obamacare,” Scott spokesperson Lane Wright said.
Under the law, states must get approval from HHS for their exchange plan by January 2013, but a conditional approval can be given if a state is on track to be ready to implement its exchange plan by January 2014.
Larsen held out hope that states would get on board and begin to lay the groundwork for the exchanges; he stated the federal government would be ready to step in and impose an exchange system if a state did not do so.
“If a state on January 2013 has not received approval or conditional approval, then we would be able to have an exchange in place by 2014,” Larsen said.
Yet most states are trying to avoid the federally imposed exchanges.
Two federal judges have declared the Affordable Care Act’s individual mandate, which imposes a tax or penalty on individuals who do not obtain health insurance, unconstitutional. One of those rulings came from a Pensacola judge in a lawsuit filed by Florida and 25 other states against the health care law. The Atlanta 11th Circuit Court of Appeals heard oral arguments in the case last month but has yet to issue a decision. In a separate lawsuit, the 6th Circuit Court of Appeals upheld the individual mandate as constitutional last month.
The issue will likely be settled by the U.S. Supreme Court, but in the interim, states opposed to the Affordable Care Act are caught between readying themselves for it, or counting on its cancellation by the courts.
“All we know is that a (federal judge) in Florida has ruled it unconstitutional, so we’re not going to be implementing it,” Wright said.
Scott stated in February, after the ruling in the Florida case, that he did not anticipate the law being upheld and he would not move to implement it until its legal fate was settled. He insisted that Florida would be ready if the law was deemed constitutional, despite the lack of preparation.
“I personally always believed it was going to be repealed. We are not going to spend a lot of time and money with regard to trying to get ready to implement it,” Scott said at the time.
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