ON AIR NOW

LISTEN NOW

Weather

Sponsored By: Two Men and a Truck
cloudy-day
91°
Sct Thunderstorms
H 94° L 79°
  • cloudy-day
    91°
    Current Conditions
    Sct Thunderstorms. H 94° L 79°
  • partly-cloudy-tstorms-day
    80°
    Morning
    Sct Thunderstorms. H 94° L 79°
  • cloudy-day
    92°
    Afternoon
    Cloudy. H 93° L 78°
LISTEN
PAUSE
ERROR

The latest top stories

00:00 | 00:00

LISTEN
PAUSE
ERROR

The latest traffic report

00:00 | 00:00

LISTEN
PAUSE
ERROR

The latest forecast

00:00 | 00:00

Obama win boosts health law, but states still control its destiny

President Barack Obama’s re-election ensures the survival of his landmark health care law, but predominantly Republican state officials will get a big say in how it is carried out.

State lawmakers will control whether millions of uninsured people get coverage through Medicaid beginning in 2014, as the law envisions. They’ll also decide whether to set up online markets where individuals can shop for coverage and seek federal subsidies to lower their costs.

Next year, at least 30 states will be led by Republican governors, and many will also have Republican-controlled legislatures. Still, most analysts believe the president’s victory will prod the nearly three dozen states --both Republican and Democratic -- that have been reluctant to move forward.

“Red states and undecided states [will] reconsider what they have been saying and doing the past few months,” said John Poelman, senior director of Leavitt Partners, a consulting firm advising states on carrying out the law, citing pressure from consumers, hospitals and other providers to expand coverage.

States have considerable sway over how the law is carried out because the Supreme Court gave them the power to reject the expansion of Medicaid, which had been expected to cover more than half of the 30 million people gaining health insurance under the law.

Since the court’s decision, six Republican governors in Texas, Florida, Mississippi, South Carolina, Louisiana and Georgia have said they will not participate, even though the federal government would cover the costs of new enrollees through 2016 and at least 90 percent thereafter.

If those governors follow through, they could significantly undermine the law’s goal of extending coverage to uninsured Americans.

Most analysts are betting that won’t be the case, however, because billions in newly available federal subsidies and intense lobbying by health providers and consumers will spur most states to reassess their positions. The most recalcitrant, such as Texas and Florida, may opt out initially.

“Not all states will expand Medicaid in 2014, but within a couple of years, all of them will have,” Poelman predicted. “That’s similar to what happened when Medicaid began in 1965. The program did not start in every state initially, but nearly all had it by 1970. Arizona was the last state to add the program in 1982.”

State Lawmakers Weigh In

State lawmakers will also play a key role in deciding whether to expand Medicaid when they convene this winter and next spring.

“When state legislatures are back in session, we expect a flurry of attention to what the states will do,” said Richard Cauchi, health program director for the National Conference of State Legislatures.

Mike Fasano, a Republican and one of the longest serving Florida lawmakers, said with the president’s win, the GOP-dominated state legislature would “take a hard look” at expanding Medicaid -- despite the opposition of Republican Gov. Rick Scott.

Fasano, who is moving from the state Senate to the state House next year, said Florida can’t afford to miss out on new revenue without having its own plan to help more than four million residents who lack health insurance.

He acknowledged that challenging Scott would be an uphill battle but said the governor’s waning popularity might embolden lawmakers.

Officials in other states insist they will opt out of the Medicaid expansion regardless of the election outcome. “An Obama victory won’t change our strategy,” said Tony Keck, Medicaid director of South Carolina, although he acknowledged it might spur questions from the Republican-controlled state legislature.

Keck said the only way state officials might consider expanding the program is if they can scale back eligibility and benefits and require Medicaid recipients to pay more for their care --- requirements the Obama administration has generally opposed.

Sandy Praeger, Kansas’ insurance commissioner and past president of National Association of Insurance Commissioners, expects many states to attempt to negotiate smaller Medicaid expansions than called for in the law.

Some, for instance, might propose expanding coverage to people who make up to 100 percent of federal poverty level ($23,050 for family of four), instead of the 133 percent ($31,000 for a family of four) required by the law. A more limited expansion would be cheaper for states that will have to start paying some of the bill in 2017. The administration has yet to say whether states can do a partial expansion.

Deadlines Loom On Exchanges

The first battles are likely to be over the health law’s new insurance exchanges, which are supposed to make it easier to find an affordable plan and to help people in small group and individual insurance market determine if they qualify for new federal subsidies.

States have to give federal regulators a plan by Nov. 16 detailing how they will move forward with their own exchanges, with enrollment slated to launch next October. Under the law, the federal government would set up exchanges where states don’t.

As of late September, only 19 had begun setting up exchanges or agreed to do so in partnership with the federal government, according to an analysis by the Kaiser Family Foundation. (Kaiser Health News is an editorially independent program of the foundation.) 

“It certainly will matter who is in the governor’s office for how states will approach the decision” on exchanges, said. Alan Weil, executive director of the National Academy of State Health Policy.

He noted the after Republican governors won in Maine and Wisconsin in 2011, both put the brakes on efforts to implement the law, which had been started by their Democratic predecessors.

But some governors who are worried about the costs are also concerned that if the federal government steps in, they may lose control over their insurance markets, said Krista Drobac, director of the health division at the National Governors Association.

Whether states that have stood on the sidelines until now can meet the tight deadlines to have the exchanges running by late next year is an open question. That timeline is also likely to be a challenge for the federal government which will have to review hundreds of insurance plans if it sets up the marketplaces in dozens of states. Consumers in federally operated exchanges may initially have fewer choices than in those run by states.

Praeger expects that Kansas and other previously undecided states will agree to partner with the federal government to move forward.

“I expect to see a lot of activity between now and Nov 16,” she said. “States will look at this more pragmatically to keep their options open.”

Read More
VIEW COMMENTS

There are no comments yet. Be the first to post your thoughts. or Register.

The Latest News Headlines

  • A Jacksonville woman has been arrested on multiple charges, after getting into a fight at the Duval County Courthouse on West Adams Street.   According to the arrest report, on Monday, August 14, Ciara Roberts, 24, was allegedly hitting two victims, including one who was holding a child at the time. The report says Roberts then took the child and proceeded to hit the second victim, while still holding the child.   As officers took her into custody, Roberts allegedly kicked one of the victims again. Upon entering the courthouse, the report says she began actively resisting and pulling away from officers.   Roberts is now charged with child neglect, battery, and resisting an officer without violence.   One of the victims had bruising to her leg, while the other was left with a scratch on his head. Thankfully, no injuries were visible on the child.   JSO didn't reveal any information about why the fight started.
  • Volstead in downtown Jacksonville will remain open under new ownership, Jacksonville Business Journal reports. Owners of the speakeasy on West Adams Street announced it was closing Aug. 21 on Facebook. The Volstead’s co-founders said that the bar wasn’t closing for any financial reason, but because of poor health was hindering one of them from running the business any longer. After a social media outcry, Volstead patrons Dana Chen and her husband, George Cunningham, reached out to the Volstead. Over the last few weeks, they quietly negotiated a purchase deal, the Jacksonville Business Journal reports. Chen and Cunningham live in Atlantic Beach and own a real estate company. Chen told the Journal that they love everything the Volstead represents and that they want to carry on the legacy and keep the drinking spot going. The Volstead will not close its doors at any point. A party is planned for Sept. 1 to celebrate its continuation.
  • It's a bizarre story out of St. Augustine.   A 22-year-old woman is facing two misdemeanor charges, after interacting with a fisherman on Tuesday.   According to the offense report from the St. Johns County Sheriff’s Office, Alexandria Turner, was swimming in the ocean at the St. Johns County Pier, off of A1A, when she allegedly swam up to a man's fishing line, cussed him out, bite his line, and then swam away with the rigging.   When deputies arrived, the report says Turner, who smelled like alcohol, became belligerent and was verbally confrontational.   At one point, a deputy claims Turner screamed several times 'I am f****** naked', causing a scene, despite her being in a bikini at the time.   Turner is now charged with disorderly intoxication and resisting an officer without violence.
  • Baltimore has removed statues that honored the Confederacy in the city overnight. Crews worked in Wyman Park starting around midnight Wednesday to remove the Lee and Jackson monument.  >> Read more trending news  They took down the statues of Robert E. Lee and Stonewall Jackson early Wednesday after the city council passed a resolution Monday that ordered the immediate destruction of the monuments, WBAL reported. The board cited the recent violence in Charlottesville, Virginia for the quick removal. “Destroyed. I want them destroyed, and as soon as possible. I want them destroyed,” city councilman Brandon Scott said Monday. The statues may be sent to Confederate cemeteries after Mayor Catherine Pugh reached out to the Maryland Historical Trust for permission to remove the monuments, WBAL reported. The removal didn’t come without cost. WBAL reported Monday that the bill could be between $1 million and $2 million. The city had four monuments to the Confederacy: a Confederate women’s monument, a soldiers’ and sailors’ monument, the Lee and Jackson monument and a statue of Robert Taney, a former Supreme Court Chief Justice who wrote the Dred Scott ruling in 1857, WRC reported. Baltimore isn’t the only area that is trying to remove its Confederate history.  North Carolina’s governor said he is trying to reverse a law that prohibits the removal or relocation of monuments in the state. Dallas’ mayor is looking at the city’s options. Tennessee’s governor called for the removal of Nathan Bedford Forrest’s bust. Forrest was an early leader of the Ku Klux Klan. The Sons of the Confederate Veterans have spoken out about the removal of the monuments across the country. “These statues were erected over 100 years ago to honor the history of the United states. They’re just as important to the entire history of the U.S. as the monuments to our other forefathers,” Thomas V. Strain Jr. told WRC.
  • The parents of Heather Heyer, the woman killed Saturday in a protest against white supremacy in Charlottesville, Virginia, remembered the 32-year-old as a big-hearted, outspoken woman who wanted equality for all. >> Read more trending news About 1,000 mourners gathered Wednesday for Heyer’s memorial in downtown Charlottesville, the same city where police said Heyer was killed while protesting what was believed to be the largest gathering of white supremacists in a decade. Heyer’s death sparked outrage across the nation and reinvigorated the debate over race relations in America. >> Related: Trump again blames ‘both sides’ for violence in Charlottesville “I think the reason that what happened to Heather has struck a chord is because we know that what she did is achievable,” Heyer’s mother, Susan Bro, said at Wednesday’s memorial service. “We don’t all have to die. We don’t all have to sacrifice our lives. They tried to kill my child to shut her up. Well, guess what? You just magnified her.” Since her daughter’s death, Bro said she’s received an outpouring of support from people wondering how to help the grieving family. She suggested that anyone wishing to help should follow Heyer’s example. “I want this to spread. I don’t want this to die,” Bro said. “This is not the end of Heather’s legacy. You need to find in your heart that small spark of accountability. What is there that I can do to make the world a better place? What injustice do I see?” Heather Heyer’s father, Mark Heyer, remembered his daughter in an emotional speech to mourners as a passionate woman who always spoke her mind. >> Related: Who is James Alex Fields Jr., suspect in deadly Charlottesville car attack? “She wanted equality. And in this issue, on the day of her passing, she wanted to put down hate,” he said. “And for my part – we just need to stop all this stuff and just forgive each other. I think that’s what the Lord would want us to do. Just to stop -- just love one another.” He said he was particularly struck by the diversity of the group gathered to mourn his daughter. “I was overwhelmed at the rainbow of colors in this room. That’s how Heather was. It didn’t matter who you were or where you were from, if she loved you that was it – you were stuck,” he said with a shaky laugh. Police said Heyer was killed Saturday when 20-year-old James Alex Fields Jr., of Ohio, slammed a car into two vehicles and protesters in Charlottesville. >> Related: Father of Charlottesville victim Heather Heyer says he forgives James Fields Fields was described by his former high school teacher as a Nazi sympathizer. He traveled to Charlottesville to participate in the Unite the Right rally, a demonstration organized by white supremacists to oppose the removal of a Confederate memorial from Charlottesville’s Emancipation Park. Mark Heyer said shortly after his daughter’s death that he forgave Fields, because “as far as I’m concerned, he was deceived by the devil.” “My daughter was fighting for equal rights, demonstrating against hatred and doing what she thought was right,” Mark Heyer told the New York Post on Sunday. “I can’t hate the man who did this to her because that would make me as bad as the people who did this.”

The Latest News Videos