Pinellas gets around state ban on Obamacare workers in health departments

Published Sept. 13, 2013

After a state ban on helping people get subsidized insurance at their local health department prompted an uproar from St. Petersburg to Washington, some quick thinking on Thursday appears to pave a path forward — at least in Pinellas County.

Florida's health departments are run from Tallahassee, where Republican leaders from the start have opposed the federal Affordable Care Act, known as Obamacare. Monday, state health officials declared that they would not allow insurance outreach workers onto their property anywhere in the state.

But Pinellas County government just received a $600,000 federal grant to work with the health department to hire and train those workers, called navigators. The decree struck a blow at this partnership considered key to the success of the insurance marketplaces that open Oct. 1.

Thursday, Pinellas County Health Department Director Dr. Claude Dharamraj, a state employee, pointed something out to officials in Tallahassee.

"All our buildings are county property," she wrote in an email. Not only does Pinellas County own the buildings, it also shares office space in four of them with the state, she observed.

"I believe I am not in the position to dictate to (the county) what kind of staff they put in their office," she wrote.

It appears her bosses agreed.

Later that day, Dharamraj notified county commissioners that the navigators will be allowed into county health department offices.

It's unclear what will happen in other counties.

"Each situation is different per county," said Nathan Dunn, a spokesman for the state Department of Health.

In Pinellas, at least, the space-sharing could lead to a scenario in which DOH staff send people across the hall for help with insurance.

Pinellas County Commission Chairman Ken Welch was relieved that a compromise was found around the state's ban.

"It reminds me of the '60s with the governor standing at the door and federal marshals having to come in," he said, referring to former Alabama Gov. George Wallace's attempts to stop desegregation of the state university by literally blocking the door to the enrollment office.

State health officials "didn't have the authority they thought they had," Welch said.

State officials said they sought to bar the navigators because they are an outside group that shouldn't have access to health department offices.

"Within an area and a facility that houses Department of Health services where we have private health information and patient information, that's going to be protected," Dunn said.

But U.S. Rep. Kathy Castor, D-Tampa, said blocking the navigators, coming on top of Florida's failure to expand Medicaid and create its own insurance marketplace, is a clear sign of politically motivated meddling.

In a letter to Gov. Rick Scott and state Surgeon General John Armstrong on Thursday, she wrote: "The continued obstruction by you and many state leaders of the Affordable Care Act is contrary to the best interests of the citizens and businesses of Florida.''

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Contact Anna M. Phillips at or (727) 893-8779.