By: Neil W. McCabe 11/21/2012 06:14 AM
The Republican governor of Florida Nov. 16 confirmed he is working with the President Barack Obama’s administration to implement its health care reforms.
“The election is over,” Gov. Richard L. Scott, who was elected governor of the Sunshine State in 2010, said in last week’s speech to the 2012 National Lawyers Convention hosted by The Federalist Society. The society is a Washington-based organization whose members are drawn from the legal community and are committed to the “original intent” of the Constitution.
By doing so, Scott aligned with governors who have embraced the next big step in the Patient Protection and Affordable Care Act. But, many of Scott’s Republican colleagues have not. As of Nov. 19, 18 states will create a state-run exchange, 16 states will not and the federal government will have to step in, according to Kaiser Health News, which has been tracking the progress of the exchanges. Six states will forge a state-federal partnership exchange and 11 states are undecided. The District of Columbia is included in the states establishing its own exchange. Among the resisters are Utah, Wisconsin and Oklahoma.
Scott said now that the campaign is over, Health and Human Services Secretary Kathleen Sebelius is on his dance card. “I will sit down with Secretary Sebelius and see if we can work out a way that reduces costs, improves access and improves quality.”
There needs to be a break between the constant politicking and campaigning because elections are about problems, he said. “Good governing is about solutions.”
The governor said he hopes he and Sebelius can work out a solution for setting up either a state-run or state-federal partnership health care insurance exchange in Florida. The former hospital chain executive said he will approach the Obama administration the same way he resolved a 30-year litigation between the federal government with Florida over ecological management of the Everglades.
“We may not be happy with the current occupant of the White House, but the question is: ‘What are we going to do about it?’” he said.
Establishing state-run exchanges was a critical dodge in the health care reform .... By making the exchanges function as state agencies, the president and Democrats could then argue that Patient Protection and Affordable Care Act was not a federal takeover of the health care industry.
State-run exchanges would be staffed and funded by the state, but the exchanges would be tightly controlled and directed by the federal government by the authority given it in Affordable Care Act.
Oklahoma lawsuit
Oklahoma has decided to do both nothing and something. With the full support of Sooner State Gov. Mary Fallin, who said she will not establish an exchange for her state, the state’s Atty. Gen. E. Scott Pruitt is suing to stop the implementation of the Affordable Care Act. Pruitt said Nov. 19 that the Oklahoma lawsuit was separate from the Affordable Care Act challenge case that was decided in the Supreme Court’s last term.
The Oklahoma lawsuit was filed in January 2011 and it is the only state-filed lawsuit left against the Affordable Care Act; it was stayed pending the resolution of other suits, he said. The stay has been lifted and the suit is active again.
Because the Supreme Court decreed the Affordable Care Act is actually a tax, Pruitt said, the federal government must follow the processes described in the Administration Procedures Act, which it is not, he said.
Wisconsin is still among the resisters. One leader in the ongoing fight against the Affordable Care Act, Sen. Ronald H. Johnson (R.-Wisc.) said Nov. 16 he welcomed Gov. Scott Walker’s decision not to set up an exchange in the Badger State.
“I fully support Governor Walker’s decision not to establish a state run health insurance exchange. He is absolutely correct that the heavy hand of the federal government will allow him little if any flexibility in setting up and operating an exchange,” he said.
“He is also right to be concerned about the federal government’s ability to honor the promises it is making to fund the exchanges and the overall healthcare law,” Johnson said. “I will work closely with Governor Walker to limit the damage that this very partisan and unpopular law will do to Wisconsin’s healthcare system and to our state and federal budgets.”
Key timeline
All federal, state-run and state-federal-partnership health care exchanges are slated to be up and running as the act takes full effect Jan. 1, 2014.
Approaching that final operational deadline, there are incremental deadlines. The first was the Nov. 16 deadline for states to declare whether or not they would create an exchange or not. Responding to a letter from the Republican Governor’s Association request for an extension to the Nov. 16 deadline, Sebelius finessed the distinction.
In a Nov. 15 letter to the RGA, Sebelius wrote that she would conflate the notification deadline with the Dec. 14 deadline for the states to produce blueprints for their state-run exchanges. The secretary did not move the Feb. 15 deadline for states to produce blueprints for their state-federal partnership exchange. If the state does nothing, then the federal government will proceed with its own exchange.
Another leader in the fight against the Affordable Care Act, Sen. Orrin Hatch (R.-Utah) said, “That HHS decided to delay the deadline on exchanges is no surprise given the insufficient guidance and information that has been given to governors.”
Hatch, who is the senior Republican on the Senate Finance Committee, said the moving deadlines and confusing rules proves the act is a mess. “Frankly, that the exchanges are such a mess is pretty emblematic of how flawed the president’s health law is–with states having to bear the brunt,” he said.
Scott said he is anxious that his acquiescence to the federal health care regime is tantamount to his becoming the deputy of the federal government, rather than the leader of a sovereign state. But, it is the everyday reality of states that they accept federal funds and federal control of virtually all they do, he said. “All the money is free money—did they explain that to you? At least, that’s the way they explain it to me.”
Illinois is the next state smaller than Florida and Illinois is spending $90 million to establish its state-run health care exchange, he said.
“So, who is going to pay for that?” In the Affordable Care Act, health care exchanges are the federally mandated marketplaces, where individual will purchase health care insurance that each state is to set up. In the absence of a state-run exchange, the federal government will set up an exchange in its place.
Scott said he estimates the cost of maintaining an exchange would be another $90 million annually. “So, who’s going to pay for that?”
Comment
Don't know Pat. Just know that one or more of the radio conservative show hosts said that is how it works. Can't remember which one/s. I know I heard it more than once. When I read the law, what I could understand of it, I did not pay that much attention to the exchanges. I was concerned regarding the death panel and the fact the government will have total access to our bank accounts. Guess you could be right, but, no matter it will get set up with Obama in the WH and Boehner waving the white flag. So we are stuck. I have seen several articles stating there is a way around it but have not had time to read them to see what they have to say. Been a bit busy lately.
Further, it seems to me and I sort of remember the supreme court telling the administration, no it could not take away medicare money if the states refused to set up the exchanges as that was their option and the feds could not force states to do something that would bankrupt their states or be something they could not afford. I know there were some articles about this, but as I remember, the way the opinion was written, it tightened the screws on the feds and left the states free from cohersion to make a good decision for their state.
No, Peggy, that is not how the law goes. The law indicates that if the states opt out of the exchanges, the federal government sets them up. They also can't kick the costs back either, so Scott should not have done this, because although the feds pay the first 2 years, the state of Florida is on the hook after that if we can't get rid of this thing. I truly would like to see Obama go and this health care bill with him, and right now, I am past caring what method gets rid of both of them!
As I understand the law, but does anyone really?, the feds are not allowed to run the health care exchanges, so it cannot be kicked back to them. That is why Perry, Haley, and others have stated exchanges will not happen in their states. It effectively puts a stop to Obamacare in their states. With spineless Boehner at the helm of congress waving his white flag, all I can say is thank God for GOP governors with guts. As for Scott, I think FCTP and others should go on a phone call and letter writing binge on Monday, if not before. Letters to the editor, letters to Scott, and other reps, etc. Just sayin'. As far as I am concerned, there is major work to be done for the next election and several thereafter. We have to tell the Rs to take their lousy candidates and shove them. They have control of almost everything as it is, and we need to take it back. They just think politics as usual will continue. The tea party has not, in my mind, done a good job with that issue. Time to roll up sleeves. Folks are going to have to state their allegiances. Do you stick with the republicans or do you go with the tea party? You can't have both. Not anymore. And by you, I mean a generic you, not you personally. Anyway, here is my take: If you always do what you always did, you will always get what you always got.
I may be off base on this, but, this is the way I see it. I think the power play on the convention floor along with some other sad/bad republican decisions have proven me correct in my assessment. No matter how much I want to be wrong, I just can't see it any other way. Time for the Rs and Ds to go the way of the Whigs and Tories in order to save the Republic, if it can still be saved. Just my take.
Well, since numerous other states opted out and kicked it back to the federal government (which will increase the costs to the federal government and increase the cost of the health care bill overall), I am disappointed Scott folded on this issue. I certainly hope somone I can vote for will be running against Governor Scott, because I truly believe this was a bad decision and a costly one.
If you're not already aware. This is what's going on in DC while dangerous criminals are allowed back out on the streets. It's horrifying that this is happening to our citizens and veterans for protesting the hijacking of our election process. This is still happening! They are STILL being tortured and treated like full on terrorists.
You may not be aware of the typical things they're forced to go through...…
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