Despite the hostility of Gov. Rick Scott and the Republican-controlled Legislature to the federal health care reform law, Florida organizations have received $119.6 million in funds from it over the last two years. A new study shows that money largely went to nongovernmental groups to fund essential health services while the state lost out on tens of millions because of the governor's opposition. So while private groups prepare, Tallahassee fiddles.
One of those missed opportunities is the money that flowed to states that started developing their own state-based health insurance exchanges. Scott's decision not to prepare for 2014, when the state exchanges are fully operational, likely means the federal government will have to establish Affordable Insurance Exchanges for Floridians instead.
Under the Affordable Care Act, private insurance coverage will be made available through state exchanges, a state-by-state, one-stop shopping center intended to give uninsured people the ability to choose from a variety of preapproved private health insurance plans. In 2014 the exchanges will provide a variety of services. They will select the health plans to be on the exchange, help consumers shop for the right one and coordinate assistance for federally subsidized premiums. Twenty-eight states have already taken steps to develop their exchanges. But for those states that opt out, the federal government will offer an exchange instead. This is where Florida is headed.
The point of states developing their own exchange is to allow for flexibility and innovation, giving each state the opportunity to meet the needs of its own residents. But Scott is intent on having Florida watch from the sidelines, even as other states with Republican governors such as Alabama prepare. Alabama received more than $8.5 million in federal exchange establishment grants after an exchange study commission, created by the Republican governor who opposes the federal law, issued recommendations for implementation.
More than two dozen additional states have received grants of up to $60 million to tackle the complexities of establishing their exchanges, including states such as Mississippi, Nevada, Michigan and others that have joined Florida's lawsuit challenging the constitutionality the Affordable Care Act. Meanwhile Florida is losing out on money that could benefit its citizens.
Florida's legal challenge will be heard by the U.S. Supreme Court in March. For now health care reform is the law of the land, contrary to Scott's assertion. His refusal to carry out the law's terms is not just an abrogation of his responsibilities as governor. It is a decision that deprives Floridians of tens of millions of dollars in federal preparatory grants, and a signal to 4 million Floridians without health insurance that they are on their own.