Committee assignment are rolling out of Tallahassee, and with the decision on a state healthcare exchange still looming, the Health and Human Services Committee has a full plate.

“I could fore see that we’re going to make some very challenging, difficult decisions about healthcare,” says St. Johns County Representative Ronald “Doc” Renuart.

Renuart was hoping for the HHS Committee assignment because he is a physician who works with the realities of the healthcare system every day. It’s those intricacies that he works with that make him sensitive to exactly what is at stake.

“There’s a lot of things that you’d think would be basic with insurances that not every state offers,” he says.

Renuart says Florida has more than 50 mandates on insurance companies requiring coverage for certain procedures.  An example he gave me was a child born with a cleft pallet will be covered to have that fixed.  He says this is not something that is offered in some other states, and casts a big shadow over a federally imposed healthcare exchange.

“Will they have to meet these same state mandates that have protected Florida’s citizens?”

By mid-December, Florida Governor Rick Scott must notify HHS Secretary Kathleen Sebelius whether Florida will implement a state healthcare exchange in order to comply with the new federal healthcare law.  This is already an extension from a deadline which passed just a few weeks ago.  If he declines, we would default to a federal exchange.

While many of your local lawmakers have told me they prefer the local control, a list of questions- ranging from cost to implementation- is keeping Scott from committing one way or the other.

“We don’t wanna price these things where the average Floridian is not gunna be able to afford them,” Renuart says.

While the federal government will cover a lot of cost during the first few years of setting up the exchange, Renuart is concerned about when they have to begin putting the cost on the people.  He says they still need a lot of guidance on these logistical questions.

Scott has asked for more information from Sebelius.

Renuart says the HHS Committee will meet beginning next week.  They are still unclear right now if any legislative action will be needed before the deadline to make the decision on setting up the state exchange, although any actual change will have to go through a vote.  If there is action needed, Renuart says a special session is not out of the question.