State lawmakers debate implementation of health care reform
Published: Monday, December 3, 2012 at 9:16 p.m.
Last Modified: Monday, December 3, 2012 at 9:16 p.m.
TALLAHASSEE — With several dozen tea party advocates urging lawmakers to resist the law in a sometimes raucous hearing, a state Senate committee on Monday began examining the new federal Affordable Care Act’s impact on the state.
The Legislature faces two key questions early next year:
- Whether the state will set up its own insurance exchange, an electronic marketplace, to offer coverage to Floridians under the new law, which has a mandate that every American have health insurance by 2014 or face a fine.
- Whether the state will expand its Medicaid coverage to more low-income Floridians.
Sen. Joe Negron, R-Stuart, chairman of the Senate Select Committee on Patient Protection and Affordable Care Act, said aims in implementing the law will be protecting individual choice, limiting regulations and promoting competition.
But the tea party advocates urged lawmakers to do everything they can to oppose the measure.
KrisAnne Hall, a former North Florida prosecutor who lost her job because of her political activity, made a lengthy plea, saying the federal health care mandate represented an “unlawful, unconstitutional encroachment on state rights.” She said lawmakers had a duty to resist the “tyrannical” law.
“Choose this day to honor your oath to the constitution, to the people who have elected you to do a job and we will be able to choose you again at election time,” she said.
“You have to resist this,” said David Heimbold, chairman of the St. Augustine Tea Party. “My recommendation to you is to divorce yourself from implementing this state mandate.”
After hearing some 10 speakers criticize the law, Senate Democratic leader Chris Smith of Fort Lauderdale argued in favor of the federal government’s role, noting it played a similar role in ending racial discrimination.
Smith, an African-American lawmaker, said under the original constitution “I wasn’t a citizen.”
If the constitution “was perfect, you wouldn’t have to amend it,” he said, drawing boos and objections from the audience.
“Nothing is forever,” replied Smith, who is a lawyer. “Sometimes you need change.”
With their annual session beginning in March, lawmakers must decide whether the state will set up its own insurance exchange under the law. The state could also create a hybrid exchange with the federal government or leave it solely to the federal government.
Health care reform also contemplates the expansion of Medicaid, the federal-state health care program for the poor and disabled, to all Floridians who earn less than 133 percent of the federal poverty level, which is about $25,400 a year for a family of three. The U.S. Supreme Court ruling that upheld the law last summer gave all the states the option of expanding the coverage, rather than making it a mandate.
Although the federal government will pick up the full expansion cost in the first three years and 90 percent in the long term, the state would face increasing costs, according to data given to the select committee.
By 2020, it could result in an increase of $330 million, with the state facing an additional 900,000 Medicaid recipients in a program that now covers some 3 million Floridians. The cost could be even higher if many of the one out of every five Floridians who is eligible for Medicaid but does not use the program now decides to sign up.
Negron cited the rising cost of Medicaid, which he pegged at $8.9 billion in 2000 but has risen to $21 billion this year, as an issue. He said the increasing cost of Medicaid limits the state’s ability to finance other critical issues, such as higher education and transportation.
Sen. Eleanor Sobel, D-Hollywood, noted the law was aimed at helping Florida deal with the third-largest uninsured population — 3.9 million Floridians or 21 percent of the state — in the country.
“We have to abide by the law and do what’s best for the people of Florida,” Sobel said.
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