The vice chairman of the Florida House of Representatives' Select Committee on Obamacare on Monday slammed the federal government for its "inflexibility" in proposing Medicaid expansions, and said states that have already decided to run their own health insurance exchanges are "guilty of malfeasance."
Rep. Matt Hudson, R-Naples, made his remarks after the first meeting of the House Select Committee on the Patient Protection and Affordable Care Act (PPACA --i.e., Obamacare), which is studying the effects of the Democrats controversial health care law on Florida businesses. The committee is also considering how the Sunshine State will apply the law.
Asked whether he had any regrets about the Florida Legislatures approach to the legislation which some have criticized as a dragging-of-the-feet Hudson replied: Absolutely not; Im not upset about our decision process at all at this point.
Under PPACA, every state will have established its own health insurance exchange program, a government-regulated marketplace from which citizens can choose from a number of approved private insurance plans. States may establish and operate their own exchanges, leave it to the federal government, or establish some sort of state-federal hybrid.
In addition, PPACA requires most citizens to purchase health insurance (or pay hundreds of dollars in penalties), and businesses with more than 50 full-time employees to provide government-approved health insurance for their employees (or, again, pay heavy penalties). The law also gives states the option to expand Medicaid coverage to all citizens with income below 138 percent of the poverty line.
Florida's already missed a December deadline to submit to the feds a health insurance exchange plan, but Republican lawmakers insist theres still plenty of time for the state to decide what it wants to do.
Hudson told reporters that Floridas reluctance to commit to a particular course of action isnt due to ideological intransigence on the part of the state Legislature, but to the Obama administrations own failure to disclose the rules that would govern the courses of action the state might take.
For example, he said, state legislators just received a summary of 144 pages of new regulations pertaining to PPACA, which were released just after Christmas.
This Act has been around for about three years and youre just now promulgating 144 pages of rules? Hudson asked. A reasonable person needs some time to understand the interplay of that. It would not be prudent to not know that information.
Hudson, a real estate agent, returned to an analogy hes employed frequently over the last few months:
Lets say you picked out a home and your Realtor came to you with a 10-page contract and said On the back page, youre gonna need to sign and date it. And you start flipping through the document and you discover Hey, wait a minute: the last four pages are blank! And your Realtor said, Trust me, it will be fine.
You wouldnt do that in your own personal life, with your own personal finances, with the biggest decision in your life, Hudson told reporters. Were making a decision that is going to affect the state of Florida for decades to come, and yetwe'vebeen given a very large, 500-page contract, but the last 150 pages are blank.
He said those states whose legislators have already committed to operating their own exchanges, with or without federal assistance, are guilty of malfeasance, for not actually knowing the rules under which they will be governed, and of not being good stewards of their taxpayers interests.
Hudson declined to speculate whether the Legislature would ultimately agree to expand Medicaid, but he did say it was very, very disappointing that theres no flexibility for Florida to choose to what degree it can extend coverage.
Later that day, the Senates own select committee on PPACA met and covered the same ground. Like its House counterpart, it did not consider any legislation; legislators were briefed by staff members on the laws various provisions, particularly those which will affect businesses.
A few business owners testified before the Senate committee and echoed Hudsons own misgivings over how much of PPACAs legal ramifications remain unknown.
I'm thoroughly confused, and I don't know what it's going to cost me next year, warned Kim Williams, president of Marpan Supply Co. We need you to study this matter expeditiously and bring us more certainty as an employer."
Republican Joe Negron of Stuart, who chairs the Senate Select Committee, said he hopes by early March to have concrete cost estimates and other recommendations to better help legislators implement the law.
Abigail MacIver, director of policy and external affairs at Americans for Prosperity (AFP) Florida, attended both select committee meetings. She told Sunshine State News she believed insurance companies were pushing legislators to implement a state-based exchange.
Theyre a very powerful lobby and theyre going to push really, really hard this year to get these state exchanges implemented, she predicted. A state exchange would mean an enormous financial influx for them: a trillion dollars over 10 years to insurance companies, by way of subsidies.
AFP is one of several conservative organizations urging state legislatures to have nothing to do with PPACA and to leave implementation to the federal government, apparently in the hope that federal insolvency might forestall implementation.
I think insurance companies find it easier to lobby at the state level than at the federal level, MacIver told the News. They are wondering how federal exchanges would continue to be created and funded, since the federal government justdoesn'thave the funds. Not all states are in a better financial position than the feds are, but Florida certainly is.
Asked what direction he believed the Legislature was leaning when it comes to the setting up of exchanges and the expansion of Medicaid, Hudson insisted it was too early to guess.
"We'veonly met as a collective body once, during the organizational session [in late November]; I cant even tell you all of my new colleagues names right now, let alone how they would actually vote, he said. Theres still a few people I pass by in the hallways, and I go, I think hes a new member.
You guys do the same thing, he joked to reporters covering the Capitol beat. You know darn well you do!
Reach Eric Giunta at email@example.com or at (954) 235-9116.