Jacksonville, FL - The consensus is that it’s not the right time, but that doesn’t mean all lawmakers are happy about handing control of Florida’s healthcare exchange over to the federal government.
“We ought to want to be in the driver’s seat, and we certainly had ample time to do that,” says Democratic State Senator Audrey Gibson, who represents parts of Duval County.
Gibson serves on the Senate’s Select Committee on the Patient Protection and Affordable Care Act, which has given the Senate President a recommendation that we default to a federal exchange. Senate President Don Gaetz says he will respect their recommendation and the Senate will not take up any state exchange legislation this session.
Not all members of the select committee share Gibson’s reservation.
“I searched hard for any valid reason why Florida should put up its resources and its money to participate. I could find none,” says Republican State Senator Aaron Bean, who represents parts of Duval and Nassau counties.
Bean is happy to hand the reins to the federal government, rather than have Florida pay for a program that’s still in the works.
“It all made sense, just to wait and see and watch what happens and let them run it themselves,” he says.
Florida Governor Rick Scott still has not officially issued his support one way or the other on a state exchange, although he let several deadlines set by the federal government lapse, meaning we were already on track for the federal exchange. This notice from the Senate makes it conclusive.
Cost was the big question for Scott, but Gibson is more concerned right now with what federal control of the system will mean for you care.
“There may be some different, tweaked areas that we could have done if we had sent notice in advance and moved towards that goal,” she says.
Some of those areas include insurance mandates the state places on private companies. As an example, Florida requires insurance companies to cover reconstructive surgery for a woman who has undergone a mastectomy. It is unclear at this time whether these state mandates will be applied under a federal exchange.
Bean tells me losing local voice is a concern, but would have been even with a state exchange.
“With an exchange, there’s very little wiggle room, it’s like we’re order takers,” he says.
His understanding is there would have been a long list of restrictions even under a state designed system, so it’s best to let all the costs fall outside the state.
Neither completely ruled out the idea for the future. Bean tells me it’s important to see how other states handle the exchange and let some of the bugs get worked out before making the investment. Gibson wants to make sure we have enough time to create the best system, which means drafting this exchange so quickly would have presented problems.