The Orlando Sentinel is reporting that Florida is poised to join the ranks of states like Minnesota and Alaska in refusing to implement key elements of the Affordable Care Act. The state is already leading the way in challenging the constitutionality of reform in the court room, but Republican gains in both chambers and the election of anti-health governor Rick Scott are empowering conservatives to take an even stronger position against the law:
And perhaps most significantly, legislative leaders are poised to block spending and rules necessary to implement the law. Already, state regulators has refused to impose minimum spending mandates that might generate refunds for consumers – but which health insurers say will hurt their profits. And Gov.-elect Rick Scott has also made clear he doesn’t want the state doing anything to help the law along. [...]
But even before he was officially named speaker, Cannon warned Crist that no state agency should take any steps to comply with the law “without clear and comprehensive guidance from the Legislature.” The Oct. 19 letter demanded an itemized accounting of all state agency activities regarding the federal law.
Specifically, the letter singled out the Office of Insurance Regulation for work it has begun – and which legislative budget-writers approved – to study how Florida’s health-care laws should be amended to conform to the federal reform, and to boost the state’s ability to handle new rate-filing data.
“Not only are Florida insurance officials helping the federal government to write rules on these matters, but [OIR] is jumpstarting these new regulatory functions by developing data systems necessary for enforcement,” Cannon complained.
He added: “We intend to develop a clear and statutorily-defined framework for Florida agencies’ activities in regard to the federal health law. Pending such legislative action, state agencies should examine each anticipated action or function in light of their specific statutory authority.”
Indeed, state attempts to stop implementation are just the most immediate consequences of the Republican victories in the midterms. While the election only strengthened the Republican strong-hold over the legislature in Florida and swept into power one of the most anti-reform governors in the nation, the GOP also won control of 26 statehouse chambers around the country and elected a slate of anti-reform governors. Sam Brownback of Kansas, for instance, has called the reform law ‘an abomination,’ Bill Haslam of Tennessee, said the law is an ‘intolerable expansion’ of federal power and a ‘reminder of the incredible arrogance of Washington,’ and Maine’s incoming governor, Paul LePage who promised to repeal the Affordable Care Act and is now preparing to eliminate Dirigo, the state’s expanded health care program.
Of course, even the most vocal Republican opponents won’t be able to repeal the federal law outright. But they will do their best to slow the pace of implementation, lean on congressional delegations to change the legislation, seek waivers (as both Florida and Maine have already done) and pressure state agencies to stop cooperating with federal requirements. The big question will be if Florida and the other anti-reform states will fall into Gov. Tim Pawlenty’s (R-MN) pattern of accepting ACA dollars while rallying against the law. The Orlando Sentinel notes that the state has already “been awarded $43 million in grants to provide $250 rebates to seniors who fall into the “donut hole” in the Medicare prescription drug program; to help prepare the Office of Insurance Regulation to evaluate out-of-state insurers seeking to sell health coverage in the state; and to plan for creating a health-care marketplace, or “exchange,” and other changes.” It’s worth asking Scott if he’s planning on sending back the money or applying for future grants.