1. Health

Florida gets $119 million in health care reform funds

Published Feb. 13, 2012

While Gov. Rick Scott has made news by rejecting several grants funded by the federal health care reform act, a study by an independent nonprofit group finds that Florida organizations have quietly received $119.6 million in reform act funds over the past two years.

Using federal data, the National Conference of State Legislatures has compiled a report that shows Florida state agencies, universities, hospitals, public clinics — even faith-based private groups such as Tallahassee-based Live the Life Ministries — received funds from the Affordable Care Act in 2010 and 2011 for everything from clinic expansion to abstinence lectures.

This has happened while Florida has been a leading state in a lawsuit alleging that the Obama administration act is unconstitutional. What's more, NCSL reports Florida is one of three states planning to ask voters next fall to consider a constitutional amendment to declare illegal key provisions of the reform act — a stance that could lead to a state-federal court battle if the amendment were to win approval. Scott, former leader of the HCA hospital chain, has been highly vocal in opposing the reform act, passed by Congress in 2010 with its most important provisions scheduled to start in 2014.

Shortly after his election in 2010, Scott announced he didn't want the state to accept $1 million in federal money, already accepted by his predecessor, Gov. Charlie Crist, that was intended to help Florida set up a health insurance exchange, a system in which small employers and individuals can join together to get lower rates usually available only to large employers.

Scott spokeswoman Jackie Schutz said the governor "believes it is imprudent to accept taxpayer money and the obligations associated with those funds if they are predicated upon implementation of a law whose constitutionality has not yet been determined by the Supreme Court."

She said that the Scott administration "carefully evaluated all federal funding opportunities" and accepted some funds in the reform act, such as abstinence counseling, because they are not tied to implementing the act.

Scott's administration also turned down an additional $1 million intended to help states determine whether health insurers were seeking unnecessarily large rate increases.

Jack McDermott, spokesman for the Office of Insurance Regulation, said the consumer funds were rejected because of concerns that accepting the $1 million would allow the federal government too much control of state insurance activities.

In other cases, Florida didn't qualify for health care funds not connected with the reform act, such as the $296 million in bonuses awarded by the federal government in December to states that had done a good job in providing health insurance for children. Much smaller states raked in considerable amounts, such as Alabama, which qualified for $19.8 million.

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Other states have been aggressive in pursuing funds to help the poor and uninsured get better health care. California has received more than $40 million to set up exchanges, according to NCSL. Altogether, California has pulled in $600 million in reform funds in the past two years.

Steven Ullmann, a health policy expert at the University of Miami, said the exchanges "are critical to the implementation of health care reform," a way of maintaining the present system of private health insurance while obtaining affordable premiums for the poor and uninsured.

Ullmann said some states, including Florida, are engaged in an "interesting gamble" by not preparing for the major reforms in 2014 because they are guessing they will never be implemented. If that bet is wrong, Florida and others will have to play catch up — and may lose control of the exchanges to the federal government. The act has a clause that if states haven't made sufficient steps toward setting up exchanges by January 2013, the federal government could take over the process.

Despite the Scott administration's opposition, Florida still ranks 10th among states in what it has received from the $4.1 billion in reform act funds distributed in 2010 and 2011, according to the NCSL.

Most of that has gone to nonstate agencies, which Scott has no control over, such as $14.5 million to expanding community health centers that serve the poor and uninsured.

One state agency that did benefit was the Department of Health, which received $2 million in September 2010, before Scott took office, to expand services. After Scott became governor, the state received $5 million in September 2011 for home-visiting programs to check on children in at-risk families, according to a U.S. Health and Human Services news release.

While the governor continues to oppose what conservatives call "Obamacare," the Obama administration has called the reform act a success in Florida, pointing out that the act saved the state's seniors $141.9 million last year because it decreased the size of the "doughnut hole" for Medicare drug costs. The administration also says the act helped 3,300 uninsured Floridians with serious medical conditions obtain insurance coverage through a high-risk pool called the Pre-Existing Condition Insurance Plan.

In one category, Florida has ranked near the top of reform funds: abstinence counseling to reduce teen pregnancy. Florida has received $2.6 million for the counseling, behind only Texas and New York, according to the NCSL.

The Department of Health received the abstinence funds, according to a federal website. Other Florida groups received another $8.8 million in other teen pregnancy counseling, with $891,000 of that going to Live the Life Ministries, with a mission of "strengthening marriages and families."

Richard Albertson, chief executive of the ministries, told the Miami Herald the funds are the first of five equal annual grants for a teen counseling program called Wait, which emphasizes that "abstinence is the best choice."

Although he accepted the federal money for his program, Albertson said he wasn't sure he supported the reform act. He said the act is "so massive and complicated that America is still learning what it's about."