Florida Too Slow with Obamacare Regulations, Say Democrats

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Florida Democrats expressed frustration with state insurance regulators Friday, accusing them of dragging their feet on drafting policies to comply with the new federal health overhaul.

For nearly two years after the Affordable Care Act became law, Republican Gov. Rick Scott and the GOP-controlled Legislature had hoped the Supreme Court would overturn the law, but justices upheld it.

“There was a philosophy, an ideology that this shouldn’t be the law even though it was the law. We don’t have a contingency plan. We’re reacting now at the 11th hour essentially and we’re flat-footed and completely underprepared to implement that law as it is,” said Rep. Dwight Dudley, a Democrat from St. Petersburg.

A House committee tasked with implementing the law including setting up ways people can choose a health plan was deluged with complicated insurance regulations during a presentation in Tallahassee about how to ensure that Florida statutes comply with the new law, leaving many with more questions than answers.

Some wondered why the state appears unprepared nearly three years after the law was passed.

“Are you saying the previous leaders of the House and Senate and the governor instructed you not to prepare to give us this information that we’re looking for now,” asked Rep. Perry Thurston, D-Fort Lauderdale.

Wences Troncoso, deputy commissioner of life and health insurance for the Florida Office of Insurance Regulation, said his agency had received a letter from former House Speaker Dean Cannon and prior leadership. And Belinda Miller, general counsel for the office, said the staff completed a draft of a bill after the federal law was passed but “we did not pursue its adoption at that time because there was no appetite to do so.”

Miller added that even if the bill had been enacted in 2010, it would have to be amended as federal health officials continue to come out with new regulations.

Republican Rep. Gayle Harrell worried the agency doesn’t have enough staff and a plan in place to handle proposals during the Legislative session.

“The deadlines are so short and we are really under the gun that I have a great deal of concern over the ability to have a market out there,” she said.

Insurance officials proposed Friday that lawmakers give them an extension to avoid a bottleneck in their agency because staffers are currently required to review health care rates within 30 days. An extension would also allow the agency to hire and train new staff, said Troncoso.

The deadline for all products to be filed is May 1, he said. The Legislative session ends May 3.

“I can understand why you’re frustrated because this torrential rain of filings is due any day and we’re now asking can we have some time and exemption and we’re hitting you at the last minute,” said Miller.

She said her agency has been working all along on the issue, but that it’s been difficult because constant updates from federal health officials have made it a fluid process.

Florida lawmakers are facing two major decisions regarding the federal health overhaul. They must choose whether to expand Medicaid coverage to roughly 900,000 more low-income families and whether to have the state run on its own the health exchange where people can pick coverages or partner with the federal government. The federal government is offering to pick up the entire tab of the Medicaid expansion for the first three years and about 90 percent after that.

Florida spends about $21 billion a year to cover nearly 3 million of the state’s poorest residents, about half of whom are children.

Scott and lawmakers also have another new wrinkle to consider.

A quirk in the federal health law means some U.S. citizens would be forced to go without coverage, while legal immigrants residing in the same state could still get it.

The overhaul expanded the federal-state program for low-income and disabled people but the Supreme Court made the Medicaid expansion optional for states. That means if Scott decides not to expand Medicaid, Floridians who were born in the U.S. may not get coverage under Medicaid, but legal immigrants could receive coverage under the exchange.

That decision could put Scott in an awkward position on immigration. He has been vocally opposed to expanding Medicaid and the federal health law, saying he is worried about the cost to Florida taxpayers.

“We are concerned about how legal immigrants and U.S. citizens are treated differently under the president’s health care law, which we continue to learn more about. The governor is focused on finding solutions that will lower cost and improve the access and quality of health care for all Florida families,” said Scott’s spokeswoman Melissa Sellers.

Arizona officials called attention to the problem last week, when Republican Gov. Jan Brewer opted to accept the Medicaid expansion.