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Heritage Foundation: Future of Obamacare in Florida Remains Murky

July 18, 2012 - 6:00pm

Insurance Commissioner Kevin McCarty told members of the Florida Health Insurance Industry Advisory Board -- meeting for the first time since June 28, when the U.S. Supreme Court ruled to uphold the Affordable Care Act -- that the ruling created ambiguity regarding the state exchanges and Medicaid expansion.

Floridacontinues to actively resist the now-optional parts of the federal plan that include federal health-care exchanges. Itis setting up a voluntaryhealth-insurance marketplacefor small businesses that goes into place next year,

Meanwhile, board members were told that little information has trickled out about what insurers -- if they participate in the subsidized exchanges -- are required to offer and how they would get paid.

These plans are supposed to be ready on Oct. 1, 2013, and these exchanges are expected to open, while were now ticking down to 14, 15 months before that and those two big questions have not been answered, said Edmund Haislmaier, the Heritage Foundations senior research fellow for health policy studies.

It becomes questionable as to whether this thing will be ready, never mind the whole issue of the exchanges to screen the information through a federal data hub.

Further stirring up the waters is the fall election.

If Democrats hold on to their majority in the Senate and continue to reside in the White House, the Affordable Care Act will proceed and consumers should expect health care cost increases, premium ratings to be imposed that penalize young people, and consumer choice to be reduced. Meanwhile, the role of agents remains in limbo.

But even if the GOP prevails in the fall, it is unknown if the entire law will be repealed or just parts, Haislmaier said.

There is a practical argument to be made for repeal, which is the thing is so unbelievably complicated if you tried to do something partial youd probably be better off starting over, he said. But it will nonetheless probably be a partisan issue.

Florida Association of Health Plans President and CEO Michael W. Garner said affordability and access remain a concern.

The premium tax under the law is expected to grow 5.7 percent a year over the next decade, according to the Congressional Budget Office, Garner said. For a small business, the increase would average $2,760 per single individual over that decade, Garner said.

Board member Laura Goodhue, executive director of the consumer-advocacy group Florida CHAIN, said any decision on the future of the exchange in Florida should be done after public meetings, allowing providers and employers to weigh in.

I think we do have some information, and enough information, two years into this law being in place to start having a public dialogue, Goodhue said.

Gov. Rick Scott, since days after the court ruled, has said that Florida will opt out of the Medicaid expansion in the Affordable Care Act and won't set up insurance exchanges in which individuals can choose private health insurance plans based on price and coverage.

U.S. Rep. Frederica Wilson, D-Miami Gardens, sent a letter to Gov. Rick Scott on Thursday stressing the need for Florida to participate fully in Obamacares Medicaid expansion.

According to the Kaiser Family Foundation, states will have relatively small increases in state Medicaid spending, but these increases will be offset by the new federal dollars that the states will receive, Wilson wrote.

The new federal dollars going to the states that participate in the Medicaid expansion will reduce the number of uninsured, create jobs, and slash uncompensated care costs. Opting out of this expansion would severely burden Florida hospitals, particularly those like Jackson Memorial in Miami and other disproportionate-share hospitals with spiraling, uncompensated costs.

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

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