The Consequences Of States Refusing To Implement Health Reform

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"The Consequences Of States Refusing To Implement Health Reform"

While most of the 26 states party to the multi-state lawsuit against the Affordable Care Act are still implementing the measure, a select few are now telling reporters that they’ll be using Judge Roger Vinson’s ruling to stop enforcing the measure. Florida’s newly-minted Governor Rick Scott (R) — who ran an anti-health reform group before running for office — is leading the charge and states like Wisconsin and Idaho are not far behind:

Florida officials made their direction clear: We will not move forward to implement this law.

Insurance Commissioner Kevin McCarty on Tuesday gave back a $1 million federal grant awarded to the state to assist with reforms. The money would have paid for a system to provide information to consumers on the rates of large-group insurers.

And Florida Gov. Rick Scott said the state will wait until the U.S. Supreme Court weighs in on the case before it plans for pieces of the legislation that haven’t gone into effect.

“We are not going to spend a lot of time and money with regard to trying to get ready to implement it,” he said.

In the Florida-led lawsuit representing 26 states, U.S. District Judge Roger Vinson ruled Monday that the law’s provision requiring people to buy health insurance or face a tax penalty is unconstitutional. He ruled the so-called “individual mandate” unconstitutional, and had to strike the law down entirely.

The administration may be considering if it should apply for a stay of Vinson’s declaratory judgment (which did not include an injunction of the law) and has argued that it will continue to implement the measure. Vinson also found that of the 26 states that took part in the lawsuit just two — Utah and Idaho — had standing to challenge the law, meaning that the other 24 may be on shaky ground if they decide to end implementation.

The biggest challenges are two-fold: 1) states that refuse to comply with the law would presumably cede control to the federal government, which would have to come in an implement the measure and 2) they would likely have to send back the millions of dollars they’ve accepted in grants. Florida has already given up a $1 million, but has received approximately $45 million. Consider:

– NORTH BROWARD HOSPITAL DISTRICT: $2,892,397
– NORTH FLORIDA MEDICAL CENTERS, INC: $2,752,713
– Osceola County Health Department: $8,313,858
– TRENTON MEDICAL CENTER, INC: $497,053
– FLORIDA DEPARTMENT OF ELDER AFFAIRS: $784,309
– FLORIDA DEPARTMENT OF ELDER AFFAIRS: $599,190
– FLORIDA DEPARTMENT OF ELDER AFFAIRS: $515,013
– FL ST DEPT OF HLTH: $2,060,128
– FL ST DEPT OF HLTH: $623,403
– FL ST DEPT OF HLTH: $909,315
– FL ST DEPT OF HLTH: $400,000
– FL ST DEPT OF HLTH: $513,415
– PINELLAS COUNTY PUBLIC HEALTH UNIT: $4,850,000
– AGENCY FOR HEALTH CARE ADMINISTRATION: $2,990,438
– AGENCY FOR HEALTH CARE ADMINISTRATION: $1,000,000
– Florida Department of Financial Services: $1,000,000
– FL ST DEPT OF HLTH: $3,405,228
– Florida State University: $1,425,600
– MIAMI CHILDRENS HOSPITAL: $4,769,280
– MIAMI-DADE COMMUNITY COLLEGE, MEDICAL CENTER: $641,520
– UNIVERSITY OF FLORIDA: $1,920,000
– UNIVERSITY OF MIAMI: $704,000

That’s a lot of money to part with, and I suspect that if Scott is serious about sending any of this back, he’ll have to fight these constituents and the representatives whose districts they’re located in. After all, even Republicans who oppose the law are always willing to lobby the government for grant dollars.

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