Florida Gov. Rick Scott (R) has refused to implement the Affordable Care Act in his state, claiming, “It’s not the law of the land. I don’t believe it will ever be the law of the land.” If the law is upheld by the Supreme Court, however, Scott could end up with no say in the matter.
Yesterday in Miami, Health and Human Services Secretary Kathleen Sebelius made it clear that Florida would have to abide by the law and form a health insurance exchange, which would allow Floridians to shop around for insurance plans, by 2014. If Florida does not take action to form an exchange by then, Sebelius promised, the federal government will do it for them:
“What we have said to states is: ‘[What] we need to know at the beginning of 2013 is whether or not you intend to do this,’” she explains. “We are responsible in the law for putting together a federal exchange for Floridians.” State lawmakers have been warned that if they fail to follow the law, the federal government will step in and create an exchange for them.“They will have a deadline to meet if they choose not to move ahead with the state based exchange,” Sebelius says. “We will launch an enrollment process and a federal exchange for the citizens of Florida.”
Scott has made no secret of his disdain for the law, even as it offers much-needed aid for the state and its residents. Rather than accept grant money to pay for disease prevention and other programs, Scott turned the money down supposedly on principle. (He did, however, accept $2.5 million for abstinence-only sex education.) Meanwhile, Florida has the third-highest rate of uninsured residents in the nation and three of the ten highest spending metropolitan areas, on top of a $3.7 billion budget deficit.
Sebelius noted that, if the federal government established an exchange in 2014, grants would start coming into the state. Until then, however, the federal government “cannot put the services together that they are turning down…unfortunately, it’s the most underserved Floridians that are the victims of that choice.” That could change within two years, but that is too long a wait for many.