By refusing to implement federal health care reform, Gov. Rick Scott and Insurance Commissioner Kevin McCarty are impeding consumer protections that Floridians are entitled to receive. Scott claims that if the U.S. Supreme Court upholds the Affordable Care Act, the state will have plenty of time to prepare. But some of the law's provisions are already in effect or will be soon, and this politically motivated decision to block progress unfairly hinders Floridians' access to affordable health insurance.
McCarty has decided to return a $1 million federal grant — money his office had applied for — that would have paid for a system that evaluates the rates charged by large-group insurers. This might not sound like a big deal, but the money was to be used to improve oversight of large-group health insurers seeking rate increases and to help implement new, more consumer-friendly medical loss ratio rules.
The new federal medical loss ratios direct insurance companies, depending upon the group size, to spend at least 80 percent or 85 percent of every premium dollar to provide or improve health care rather than on big insurance executive salaries, marketing blitzes, profits and other administrative expenses. Congressional Democrats say they won that requirement as a concession for giving up on a public option for health insurance that was opposed by Republicans and private insurers.
These rules, which went into effect this year, will ensure that people get real value for their health insurance dollar. But McCarty's office claims it is under no obligation to help enforce the federal medical loss ratios since its office views federal health reform as unconstitutional in light of Monday's ruling by U.S. District Judge Roger Vinson in Pensacola. Instead, the Office of Insurance Regulation plans to follow state law that currently imposes medical loss ratios as high as 80 percent but sets the ratios for most health insurance plans at 65 percent to 70 percent — rates that are much more generous to health insurers.
Regardless of Vinson's ruling, federal health reform has not been overturned and is still the law of the land. Two federal judges have found the law constitutional, while two have found it unconstitutional, and it may be years before the cases make their way to the U.S. Supreme Court for a final decision. In the meantime, Florida should be following federal law instead of ignoring it. That is what our nation's legal system requires, and it would make health insurance in Florida more affordable and available. Floridians are entitled to benefit from federal health care reform, and it is fundamentally unfair for the governor and the insurance commissioner to work against the interests of the very residents they are supposed to be serving.