TALLAHASSEE — Reverberations of a Florida judge's ruling that the federal health care law is unconstitutional are spreading throughout the country, with supporters and opponents of the overhaul using the decision to draw their lines in the sand.
In Washington, Republican senators called the ruling a "second stake in ObamaCare" and immediately introduced repeal legislation with plans for a vote today. Nationwide, attorneys general, governors and consumer groups debated the impact of the ruling on changes that have already taken place and those in the works.
Florida officials made their direction clear: We will not move forward to implement this law.
Insurance Commissioner Kevin McCarty on Tuesday gave back a $1 million federal grant awarded to the state to assist with reforms. The money would have paid for a system to provide information to consumers on the rates of large-group insurers.
And Florida Gov. Rick Scott said the state will wait until the U.S. Supreme Court weighs in on the case before it plans for pieces of the legislation that haven't gone into effect.
"We are not going to spend a lot of time and money with regard to trying to get ready to implement it," he said.
In the Florida-led lawsuit representing 26 states, U.S. District Judge Roger Vinson ruled Monday that the law's provision requiring people to buy health insurance or face a tax penalty is unconstitutional. He ruled the so-called "individual mandate" unconstitutional, and had to strike the law down entirely.
Vinson declined to issue an injunction against the federal law, but said he believed the federal government would treat his ruling as one.
That's how Florida Attorney General Pam Bondi sees it.
"What he's saying is, they need to follow the law. This is the law as he's ruled. They need to do the right thing," she said in a news conference shortly after the ruling was released.
In Wisconsin, Attorney General J.B. Van Hollen agreed: "For Wisconsin, the federal health care law is dead — unless and until it is revived by an appellate court. Effectively, Wisconsin was relieved of any obligations or duties that were created under terms of the federal health care law. What that means in a practical sense is a discussion I'll have in confidence with Gov. (Scott) Walker, as the state's counsel."
But at least one insurance industry group plans to continue abiding by the new federal rules.
"Health plans will, of course, continue to meet their obligation to implement the new law on behalf of the more than 200 million people we serve," said Robert Zirkelbach, spokesman for the Washington, D.C.-based America's Health Insurance Plans, which represents nearly 1,300 health plans.
That includes covering pre-existing conditions and allowing children as old as 26 to remain on their parents' policies.
Still, Zirkelbach emphasized that throughout the health care debate, the insurance industry has argued that the individual mandate was critical to making sure health care companies could cover the costs of providing services to people regardless of pre-existing conditions and other risk factors.
"States that have implemented these laws without covering everyone have seen a rise in insurance premiums, a reduction of individual insurance enrollment and no significant decrease in the number of uninsured," he said.
Another push for repeal
In the nation's capital, Senate Republicans on Tuesday seized on attention given to the Florida ruling to push their effort to repeal the law.
GOP leader Mitch McConnell offered a repeal amendment to an aviation bill and encouraged Democrats to come on board.
"What we have today is an opportunity ... to take another path," McConnell said.
The Republican-led House has already passed the repeal.
As the debate heated up, phones started ringing in Democratic offices across Capitol Hill, including Florida Sen. Bill Nelson's, with callers urging support of the repeal.
The effort was organized by FreedomWorks, a Republican group that provided organizational support to the tea party. Nelson has said provisions can be tweaked but does not favor wholesale repeal.
One certain change: Eliminating a requirement that businesses file a tax form for purchases of goods or services of more than $600. Both parties agree it is onerous.
But Democrats were refusing to budge on bigger changes, noting that Republicans have not offered specific replacements.
Scott's stance criticized
Gov. Scott promised that if the country's high court ultimately backs the overhaul, Florida will have plenty of time to prepare.
"The state won't be caught flat-footed," he said. "We'll be ready."
The stance taken by Scott, who before he ran for governor founded the nonprofit Conservatives for Patients' Rights to fight the legislation, prompted vitriol.
"I fear that what began as his own personal vendetta against the president's health care initiative has morphed into a personal war using the governor's office as his launching pad," said Florida Sen. Nan Rich, D-Weston.
Ethan Rome, executive director of Health Care for America Now, said Scott's position was to be expected, given he is the former CEO of the Columbia/HCA hospital chain.
"It doesn't surprise me that Gov. Scott would take the side of the insurance industry and say, 'I want them to make more profits and make more money and that's more important to me than protecting the citizens of my state from the abuses of the insurance industry,' " Rome said.
He noted that Vinson is "one of four judges of equal rank" that ruled on the law, and two of the judges upheld it.
"States need to move forward with implementation of the law in a responsible and quick way and do right by the people in their states," Rome said. "This decision doesn't change that one bit."
Times staff writers Alex Leary and Michael C. Bender contributed to this report. Janet Zink can be reached at firstname.lastname@example.org or (850) 224-7263.