Legislature nearing decisions on implementation of Obamacare

By on February 19, 2013
obamacare

A Senate select committee could make recommendations March 4 about key parts of the federal Affordable Care Act, including whether Florida should move forward with a major expansion of the Medicaid program.

Sen. Joe Negron, a Stuart Republican who is chairman of the select committee, said Monday he expects an opportunity to hear “closing arguments” during a meeting March 4 — a day before the start of the annual legislative session. Negron said his goal has always been to make recommendations during the first week of session.

A House select committee also appears to be on a similar schedule. That panel has scheduled a meeting Feb. 28, an off week for the Legislature, and probably will meet at least twice during the first week of session, said Chairman Richard Corcoran.

“We’re trying to keep pace with the Senate,” Corcoran said after his committee heard more than three hours of presentations Monday.

Lawmakers face a series of decisions during the upcoming session about the Affordable Care Act, with the potential Medicaid expansion the most controversial. The Senate select committee Monday rejected any remaining possibility that Florida would run a health-insurance exchange in 2014, another issue that has drawn heavy attention.

Legislative leaders have said for weeks that they expected the federal government to run the state’s exchange, which will serve as an online marketplace for people to shop for health-insurance coverage. Republicans and Democrats on the Senate panel agreed Monday to formally recommend that the Obama administration run the exchange, a move that came after Florida had missed deadlines for notifying the federal government of plans to operate a state exchange.

“I’m still looking for a valid reason why we would ever want to start our own exchange,” said Senate Health Policy Chairman Aaron Bean, a Fernandina Beach Republican who serves on the select committee.

Other lawmakers said Florida could operate an exchange in later years if it decided to do so. Sen. David Simmons, R-Maitland, said questions remain unanswered about the exchanges and that Florida should let the federal government “show us the way.”

“If there are going to be mistakes made, we can learn from their mistakes,” Simmons said.

The select committees have been listening to testimony and gathering information for weeks, and their positions could be an important indicator as the full Legislature gets ready to tackle the Affordable Care Act. Among other things, lawmakers will have to resolve complicated insurance-regulatory issues and a question about expanding the state’s health-insurance program to offer coverage to many temporary employees.

But the Medicaid issue — and particularly its potential costs for the state — has drawn the most scrutiny. As an example, supporters of the Medicaid expansion accused Republican Gov. Rick Scott earlier this year of inflating the estimated costs of such an expansion. Scott has been a longtime critic of the federal law, which President Obama and congressional Democrats approved in 2010.

Also, groups such as the hospital industry are lobbying heavily for the expansion. Three hospital executives told the House select committee Monday that enrolling more people in Medicaid would reduce the amount of uncompensated care they have to provide when uninsured people show up in emergency rooms.

But Corcoran said after the meeting that the executives lacked data to show how their hospitals would be affected.

The Affordable Care Act says Washington will pay 100 percent of the costs of expanding Medicaid eligibility during the first three years and 90 percent of the costs later. The expansion could provide coverage to hundreds of thousands of people in Florida, primarily childless adults who don’t currently qualify for Medicaid.

Amy Baker, coordinator of the state Office of Economic & Demographic Research, said state analysts will meet March 1 to revise cost estimates. That information then will go to the select committees, which will hold a joint meeting during the morning of March 4 before holding separate meetings later in the day.

The analysts will have to wade through issues such as projecting how many newly-eligible Medicaid beneficiaries would actually enroll in the program and trying to figure out how much it would cost to provide coverage to them. While the federal government would pay most of the costs in the coming years, the state would eventually have to pick up part of the tab.

Analysts also will grapple with estimates for people who are currently eligible for Medicaid but have not enrolled in the program. Baker said there is wide-ranging agreement that some of those people will enroll in Medicaid as the Affordable Care Act takes effect.

Via Jim Saunders of the News Service of Florida.

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