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RICK SCOTT CAVES
Rick Scott caves to health exchange, but other GOP-led states hang tough
The Republican governor of Florida Nov. 16 confirmed he is working with the President Barack Obama’s administration to implement its health care reforms.
“The election is over,” Gov. Richard L. Scott, who was elected governor of the Sunshine State in 2010, said in last week’s speech to the 2012 National Lawyers Convention hosted by The Federalist Society. The society is a Washington-based organization whose members are drawn from the legal community and are committed to the “original intent” of the Constitution.
By doing so, Scott aligned with governors who have embraced the next big step in the Patient Protection and Affordable Care Act. But, many of Scott’s Republican colleagues have not. As of Nov. 19, 18 states will create a state-run exchange, 16 states will not and the federal government will have to step in, according to Kaiser Health News, which has been tracking the progress of the exchanges. Six states will forge a state-federal partnership exchange and 11 states are undecided. The District of Columbia is included in the states establishing its own exchange. Among the resisters are Utah, Wisconsin and Oklahoma.
Scott said now that the campaign is over, Health and Human Services Secretary Kathleen Sebelius is on his dance card. “I will sit down with Secretary Sebelius and see if we can work out a way that reduces costs, improves access and improves quality.”
There needs to be a break between the constant politicking and campaigning because elections are about problems, he said. “Good governing is about solutions.”
The governor said he hopes he and Sebelius can work out a solution for setting up either a state-run or state-federal partnership health care insurance exchange in Florida. The former hospital chain executive said he will approach the Obama administration the same way he resolved a 30-year litigation between the federal government with Florida over ecological management of the Everglades.
“We may not be happy with the current occupant of the White House, but the question is: ‘What are we going to do about it?’” he said.
Establishing state-run exchanges was a critical dodge in the health care reform .... By making the exchanges function as state agencies, the president and Democrats could then argue that Patient Protection and Affordable Care Act was not a federal takeover of the health care industry.
State-run exchanges would be staffed and funded by the state, but the exchanges would be tightly controlled and directed by the federal government by the authority given it in Affordable Care Act.
Oklahoma lawsuit
Oklahoma has decided to do both nothing and something. With the full support of Sooner State Gov. Mary Fallin, who said she will not establish an exchange for her state, the state’s Atty. Gen. E. Scott Pruitt is suing to stop the implementation of the Affordable Care Act. Pruitt said Nov. 19 that the Oklahoma lawsuit was separate from the Affordable Care Act challenge case that was decided in the Supreme Court’s last term.
The Oklahoma lawsuit was filed in January 2011 and it is the only state-filed lawsuit left against the Affordable Care Act; it was stayed pending the resolution of other suits, he said. The stay has been lifted and the suit is active again.
Because the Supreme Court decreed the Affordable Care Act is actually a tax, Pruitt said, the federal government must follow the processes described in the Administration Procedures Act, which it is not, he said.
Wisconsin is still among the resisters. One leader in the ongoing fight against the Affordable Care Act, Sen. Ronald H. Johnson (R.-Wisc.) said Nov. 16 he welcomed Gov. Scott Walker’s decision not to set up an exchange in the Badger State.
“I fully support Governor Walker’s decision not to establish a state run health insurance exchange. He is absolutely correct that the heavy hand of the federal government will allow him little if any flexibility in setting up and operating an exchange,” he said.
“He is also right to be concerned about the federal government’s ability to honor the promises it is making to fund the exchanges and the overall healthcare law,” Johnson said. “I will work closely with Governor Walker to limit the damage that this very partisan and unpopular law will do to Wisconsin’s healthcare system and to our state and federal budgets.”
Key timeline
All federal, state-run and state-federal-partnership health care exchanges are slated to be up and running as the act takes full effect Jan. 1, 2014.
Approaching that final operational deadline, there are incremental deadlines. The first was the Nov. 16 deadline for states to declare whether or not they would create an exchange or not. Responding to a letter from the Republican Governor’s Association request for an extension to the Nov. 16 deadline, Sebelius finessed the distinction.
In a Nov. 15 letter to the RGA, Sebelius wrote that she would conflate the notification deadline with the Dec. 14 deadline for the states to produce blueprints for their state-run exchanges. The secretary did not move the Feb. 15 deadline for states to produce blueprints for their state-federal partnership exchange. If the state does nothing, then the federal government will proceed with its own exchange.
Another leader in the fight against the Affordable Care Act, Sen. Orrin Hatch (R.-Utah) said, “That HHS decided to delay the deadline on exchanges is no surprise given the insufficient guidance and information that has been given to governors.”
Hatch, who is the senior Republican on the Senate Finance Committee, said the moving deadlines and confusing rules proves the act is a mess. “Frankly, that the exchanges are such a mess is pretty emblematic of how flawed the president’s health law is–with states having to bear the brunt,” he said.
Scott said he is anxious that his acquiescence to the federal health care regime is tantamount to his becoming the deputy of the federal government, rather than the leader of a sovereign state. But, it is the everyday reality of states that they accept federal funds and federal control of virtually all they do, he said. “All the money is free money—did they explain that to you? At least, that’s the way they explain it to me.”
Illinois is the next state smaller than Florida and Illinois is spending $90 million to establish its state-run health care exchange, he said.
“So, who is going to pay for that?” In the Affordable Care Act, health care exchanges are the federally mandated marketplaces, where individual will purchase health care insurance that each state is to set up. In the absence of a state-run exchange, the federal government will set up an exchange in its place.
Scott said he estimates the cost of maintaining an exchange would be another $90 million annually. “So, who’s going to pay for that?”
Views: 86
Comment
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Comment by amanda choate on November 28, 2012 at 4:23pm
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The $100 is the penalty imposed on those who choose not to participate. Cheap.
If your sister can't afford insurance now, then the government will assist her purchase of insurance. If she has coverage now, she won't be impacted. The facts are these, premiums have gone ups slower in the last three years than at any time in the previous sixtenn years. There is a fact for you.
Single payor was the cost efficient way to go, but that would be socialized medicine and no one is for that. We had to keep it privatized so that insurance companies can keep on getting theirs. I did get a premium refund this year of $63 because my insurer spent less than 80% of premium dollars on patient care.
And no I do not drink the conservative media koolaid. But there are great places to go to read real conservative voices and not just those playing people for fools.
If you think I am wrong, go back to 2008 and read again what Rush and Glenn and Drudge said would happen by now. It hasn't happened. There are conservative voices out there who have gotten pretty much everytthing right though. They have been dead on accurate.
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Comment by Peggy Hall on November 26, 2012 at 8:27am
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Pat, I am afraid your sister is stuck from all that I hear and read. The exchanges are to force people to certain insurances, then to single payer. The total destruction of the American health care system. Liberals will be exceptionally happy. And even if you pay your doctor CASH, the government will know EVERYTHING about you. I have spoken with several doctors, one just last week, regarding the issues. LOL, I have had plenty of opportunity to speak with docs about it this year.
I don't like Kool Aid. LOL. None of the flavors. Hopefully, we can all become intelligent enough and think for ourselves and not follow the talking points, especially those from the White House and MSLSD, er, MSNBC.
Amanda is just a rude, ignorant leftie. She has no respect for anyone but herself. You know how they are. You are wonderful in their eyes, as long as you totally agree with them. If you do not, out comes the Saul Alinsky playbook. Rule 5 has been used so excessively, it should be worn out by now.
And as for Amanda, if she gets her wish, she will be wearing a garbage bag, er sorry, burqa, and that is IF she is not gay and stoned to death. Hey on the bright side of things, all that material in the garbage bags may prevent some of the hits and kicks from breaking some of her bones.
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Comment by Patricia M. McBride on November 26, 2012 at 7:49am
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Peggy, there is no need to Amanda to do what she does. She is all about insulting and attacking on the most mundane of comments, and it makes her look childish and petty. I understand she doesn't realize it does, but it does. I understand you keep abreast of what is going on and so do I, and unlike Amanda, we aren't drinking the koolaid and presenting information which is not altogether accurate either. The idea of the blogs is to share information and ideas.....................and now I have done the very thing I am saying we shouldn't do :).
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Those are the kinds of numbers my sister is quoting Peggy. I have been trying to think of some way she can get into some kind of a group insurance program and mostly they cost more than she can afford and she isn't yet poor enough to get any help, but this president is certainly trying to put her there along with tons of other people.
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Geesh Pat, why do you bother? The conservative radio slam was for me. Now, all I said is I get my news mostly from radio. Did I say conservative? NOPE. Amanda as you know, is an Occupy Wall St. recruiter, muslime (sic) lover and lover of sharia, and on top of those, a total idiot. You waste your breath my friend.
I will pray for your sister. And you are 100% correct that the "tax" for the healthcare mandate is MUCH more than 100 dollars. If anyone on TV or radio has a clue as to what is going on in that monstrosity of a piece of you know what bill, it will be about $2000.00 to $2200.00. Maybe Amanda's commie mulsime (sic) messiah will change that or has changed that, but, that is where it was set when the bill was shoved down our throats like all good commies do.
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Amanda, you are also uninformed. The cost for not buying insurance starts out low (and I question your scant $100), but it does not stay there. The cost of not having insurance increases every year you don't buy it and becomes a budget breaker after a couple or 3 years. I know, I have a sister who will be impacted by this and she can quote right to the dime what it will cost her, but she can't afford insurance, because of the policies of this administration and what the associated economy is doing to her business...............her income which was already pretty low is even lower. You may rest assured she knows right to the penny what it will cost, and it isn't a pretty picture for her given this horrid man does something daily to hurt small businesses and people like my sister. How many others like her are in the same dire straights? Probably many. As far as your ASSUMPTION that I get my news from talk radio, you might reconsider making assumptions not based on facts you can present (and you have none). You don't have a clue in the world where I get news, and your comment was meant to insult more than anything else, so if you want to have any credibility yourself, knock it off! And I do not owe anyone else to pay their cost of health insurance.............let them get a job and pay for their own! Our medicare went up about $100.00 this month combined, but we are in the 50% of the country that actually pay for benefits.
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Conservative radio talk shows are not where one goes to get facts. It is where one goes to get mad. They are wrong more than right.
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Let's start with the mandate. Should one opt out of buying insurance the tax is about $100. That is what all the huulabaloo is about. Second it is not the end of freedom except for those who choose to have others pay their medical bills for them. It is not what we need either. If you want to keep medicare then everyone should be a part of it with individuals being able to buy ancillary coverage. Then you make it all work. Medicare fails because we don't have anyone but the old and sick in it and we don't pay for it.
As soon as you want to have substantive discussions let me know. But go out and learn the facts.
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We were talking about 2 things Amanda, so I don't think we are quite the idiots your comments would indicate we are. I had hoped above hope that this would never be an issue, but it is along with a great many other things that are going to kill our families and every one we know plus all the businesses in America while this America hater goes on living a life a leisure and acting like he actually knows what he is going................and maybe he does and the destruction of the country was always his plan. I can tell you that other governors have said it doesn't matter which of the 3 choices they give you that you take, because the end result is the same...............and all the talk about flexibility is a myth. There is no flexibility, so Governor Scott made a huge blunder period.
And Amanda rather than treating us like we are the most stupid people you have met, you might have joined in an enlightened us since you seem to feel you know everything!
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Wow, is there any way you two could know less about this issue. You pretty much got every point wrong, and that was with you taking both sides. Truly amazing. Yes there is plenty wrong woth this bill, so you don't have to make it up. Scott's position gives him the most flexibility to build an exchange that benefits him and his cronies.
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