Sun Sentinel's Health Reform Article

This morning's Sun Sentinel had a great article in it about Florida and the Health Care Reform.  I thought I would share it with all of you:

"Feds may act if Florida stalls on health-reform law

Hoping legislation will be repealed, Scott rejects grants, blocks compliance

By: William E. Gibson, Staff Writer

WASHINGTON ——

If Florida leaders refuse to carry out the new national health care law, Uncle Sam is prepared to take charge on behalf of the state's consumers.

One year after President Barack Obama signed the health care overhaul into law, federal officials are urging Florida and other reluctant states to shape it to meet their needs and to take advantage of millions of dollars of federal planning grants. Failure to participate, officials warned this week, means a loss of state control.

Florida and other states, for example, must show by 2013 they are set up to provide a health insurance exchange, an online service for consumers to compare coverage plans and shop for affordable rates. If states are unwilling or unprepared, the law requires U.S. officials to step in and make a federally run exchange available for residents at the start of 2014.

But Florida Gov. Rick Scott, backed by fellow Republicans in the Legislature who strongly oppose "ObamaCare," has refused $2 million in federal planning money and ordered state agencies not to implement the law. In addition, Florida has challenged the law in federal court, in a lawsuit filed before Scott was elected in November.

The standoff reflects an ongoing political debate and a high-stakes gamble by Scott and other critics, who are counting on Congress to repeal the law or federal courts to rule it unconstitutional. Other states are quietly preparing to comply, even while challenging some of the law's provisions in court.

"Of all the states, Florida is obviously one that has been the most reluctant to get out in front and engage in innovative ways to exercise their flexibility to implement the law," said Paul Dioguardi, director of intergovernmental affairs at the U.S. Department of Health and Human Services, in an interview this week.

"What Governor Scott is really leaving on the table is the ability to implement the law of the land in a way that makes sense for Florida," Dioguardi said. "What we're left with is this federal fallback mechanism, which would be a missed opportunity for them to do it in a good Florida way."

Scott, who also refused more than $2.4 billion of federal high-speed-rail money, is trying to wean Florida from federal aid and to block mandates imposed by the health care law. Those mandates, scheduled to take effect in 2014, include expansion of Medicaid and requirements that individuals obtain health insurance.

The governor has told reporters in Tallahassee that state officials were "not going to spend a lot of time and money" to implement the law. But he promised that "the state won't be caught flatfooted. We'll be ready" if it should be upheld by the courts.

In the meantime, he has refused a $1 million grant to plan for the insurance exchange and another $1 million grant designed to track premiums to prevent unreasonable rate hikes.

"We believe the federal law is unconstitutional, in which case it won't be enforced," said Jack McDermott, spokesman for the Florida Office of Insurance Regulation.

A federal judge in Pensacola has declared the law unconstitutional, though the law has been upheld by other courts. The U.S. Supreme Court is expected to ultimately settle the matter.

The law's proponents accused Scott on Wednesday of resisting implementation out of political spite.

"It's purely a result of his venom toward the fact that it was passed," said U.S. Rep. Debbie Wasserman Schultz, D-Weston. "I think he needs to stop acting childish, be a grown-up and do what he is supposed to do to make sure the state is ready to implement the law."

Republicans in Congress vowed Wednesday to keep pressing for repeal.

U.S. Rep. Allen West, R-Plantation, called the law "a costly and unworkable maze of new federal agencies and empowered federal government bureaucrats who determine the what, when, where and how of health care."

U.S. Sen. Marco Rubio, R-Fla., said the law "is adding to our nation's debt, destroying jobs and threatening current coverage plans that people are satisfied with."

Meanwhile, provisions are gradually kicking in, and other states are tapping federal grants designed to help consumers, prevent fraud, develop the health care work force and prepare for the insurance exchanges.

"You can play catch-up, but the longer you wait, the harder it gets," said Alan Weil, executive director of the National Academy for State Health Policy, an independent group of state policymakers.

Weil said most states are eager to run the exchanges, which will be funded by the federal government. But he said Floridians might be better served by a federal exchange.

"If a reluctant state doesn't want to do it," he said, "it may be better for the consumer for an enthused federal government to take the lead.""