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Florida Senators Say No to State Run Health Care Exchange

February 17, 2013 - 6:00pm

The committee reviewing how Florida should respond to the federal health-care law agreed Monday not to pursue setting up a state run exchange.

At least, not for the next year or two.

Meanwhile, a decision on the massive expansion of Medicaids managed care program in Florida is now tentatively set for March 4, the day before the 2013 regular session begins.

Sen. Joe Negron, the chairman of the Senate Select Committee on Patient Protection and Affordable Care Act, said the pre-session directive depends upon updated long-term cost estimates on the impact to Florida from the expansion of Medicaid from state economists and Florida securing a long-awaited waiver on the program.

Id feel much better about contemplating that issue knowing that our waiver has been granted, said Negron, R-Stuart.

Earlier this month, the Obama administration approved the first of the two waiver requests from Florida, to move long-term care patients into managed care programs.

With Medicaid eating nearly one-third of the states budget, the second waiver is considerably larger and potentially a key to Florida accepting the expansion of Medicaid as outlined in the Affordable Care Act.

The cost of the expansion to Florida has been widely estimated in past months.

A study by the Washington, D.C.-based Kaiser Commission estimated last November that adding 1.6 million people to a government-run insurance program for the poor would cost Florida about $8.9 billion over the next decade.

In January, the state Agency for Health Care Administration, which manages Florida's Medicaid program, put the cost about $3 billion in the same timeframe.

On Monday, members of the Senate Select Committee, both Republican and Democrats (reluctantly), formally pointed to the limited time to meet the fall 2013 deadline to set up an exchange, as well as still unanswered questions regarding the federal law in agreeing not to proceed with plans for a federal exchange this year.

It just seems there are too many unanswered questions for the state to be jumping into this without letting the federal government show us the way for at least the first year, said Sen. David Simmons, R-Altamonte Springs.

I have no desire to be first, added Sen. Jeff Brandes, R-St. Petersburg.

Committee members will formally write their collective opinion to Senate President Don Gaetz, R-Niceville, who had asked their input on the potential to proceed with a state-run exchange.

The federal deadline for the states acceptance went quietly without a response from Florida on Friday, but Negron said he considers most deadlines flexible as Florida isnt the only state the federal government is working with on the issue.

And while he would have been surprised if the committee agreed to move forward with the exchange, the state still could have had time.

If we decided today we wanted to do a state exchange, we could do a state exchange, Negron said.

But I was hearing the state evidence as everybody else and there wasnt a compelling case to do a state exchange.

The U.S. Supreme Court's ruling last summer on the Affordable Care Act allowed states to opt out of the law's Medicaid expansion, leaving each state's decision to participate in the hands of the nation's governors and state leaders.

Gov. Rick Scott, who has been trying to work with U.S. Health and Human Services Secretary Kathleen Sebelius on the states implementation of the law, already emphatically announced in December that Florida would have an exchange in place by Oct. 1, 2013.

Any formal action from the state Legislature must still go through legislative review process, including stops in the Banking and Insurance Committee, Appropriations Committee, and the Health Policy Committee, Negron said.

Each committee is headed by Select Committee members who voiced opposition to establishing the exchange on Monday -- Negron on Appropriations, Simmons on Banking and Insurance and Sen. Aaron Beach, R-Fernandina Beach, on Health Policy.

Im still looking for a valid reason why wed ever want to start our own exchange, so right now I think we should let the federal government do it until its proven otherwise, said Bean.

Sen. Darren Soto, D-Orlando, said the committee should also begin to consider options that would allow the infrastructure for a state run exchange to proceed some years in the future.

Sen. Eleanor Sobel, D-Hollywood, said the minority caucus reluctantly agreed because there hasnt been much activity from the state to create the exchange.

Reach Jim Turner at or at (772) 215-9889.

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