SORE LOSER?

Gov. Rick Scott says to hell with implementing ‘Obamacare’ in Florida, thus hurting thousands of Black Floridians who would immediately benefit from the legislation.

COMPILED FROM STAFF REPORTS

In the most watched U.S. Supreme Court case since Bush v. Gore in 2000, the justices upheld the landmark Affordable Health Care Act that requires all Americans except those objecting on religious grounds or facing financial hardship to obtain health insurance by 2014 or pay a financial penalty.

The ruling grew out of three cases challenging the constitutionality of the Affordable Care Act that were appealed to the Supreme Court – including a lawsuit filed by the state of Florida, instituted by former Florida Attorney General Bill McCollum, continued by his successor Pam Bondi, and supported by Gov. Rick Scott.

President Obama signed the legislation into law in 2010. Most of its provisions will be phased in over the next two years.

Among other things, the law prohibits insurance companies from denying coverage based on a pre-existing condition, allows children to remain on their parents’ insurance plan until age 26, expands access to insurance to 30 million Americans, eliminates annual and lifetime coverage caps, creates insurance exchanges at the state level for individuals and small businesses, expands eligibility for Medicaid and requires insurance companies to cover certain preventive services without co-pays or deductibles.

Impact on Blacks
According to an analysis by the Urban Institute, the number of uninsured African-Americans under the age of 65 will drop from 7.4 million to 3.4 million as a result of the health  care law, a decrease of 54.6 percent. Black Floridians are about 7.1 percent of America’s total Black population, which means that an additional 684,000 Black Floridians would be insured under Obamacare.

But some problem areas remain. Health Affairs magazine concluded, “Of the estimated 26.4 million individuals projected to be uninsured after the implementation of the Affordable Care Act, those eligible for Medicaid and CHIP (the Children’s Health Insurance Program) but who remain unenrolled, constitute the single largest group, at 35.7 percent. This eligible-but-unenrolled group includes 58.8 percent of the Blacks who we estimate will remain uninsured under the Affordable Care Act, which is a higher proportion than found in the other racial and ethnic groups examined.”

For the law to have impact, effective outreach programs must be used to reach those less likely to enroll in Medicaid, a state and federal partnership that provides medical coverage for needy families, pregnant women, children, the blind and the elderly, and CHIP, also a federal matching fund for states to provide health coverage to nearly 8 million children in families with incomes too high to qualify for Medicaid, but can’t afford private coverage.

An important limit
Under Obamacare, Medicaid was expected to extend coverage to about 17 million Americans by covering everyone below 133 percent of the federal poverty line – approximately $14,500 for individuals. The administration had said that states that refused to go along with the change would lose their federal match.

The ruling now allows states to opt out of expansion without losing their federal funds. Now, Florida will opt out of spending about $2 billion more to expand Medicaid, and won’t build insurance exchanges, another optional part of the federal health care law, Scott’s office said.

Scott also noted that Obamacare doesn’t take effect until 2014 and nothing in it is required of states before the 2012 general election, when Republicans hope to unseat President Obama. Republican presidential candidate Mitt Romney has pledged to repeal the act.

Billions turned down
Turning down the expansion of Medicaid means turning away most of the money to pay for it. Washington would have picked up 90 percent of the cost, and all of it in the first couple years.  But even that small state portion of new spending would be too much, Scott concluded. (Florida now pays about 45 percent of the cost of Medicaid.)

Scott also noted that some families already are covered in Florida at the 133 percent of poverty level that the new law calls on states to do – and Florida has a children’s health insurance program, KidCare, which prevents children whose families sign up from going without health coverage.

Another part of the health care law gives Florida the flexibility to opt out of building insurance “exchanges” that Washington billed as a way of helping residents find health coverage. Scott said it would cost too much.

Critics object
Karen Woodall, an advocate at the Florida Center for Fiscal and Economic Policy, said expanding Medicaid would create 65,000 Florida jobs over five years.

“Medicaid expenditures go to hire people,” Woodall said. “They go to pay physicians, nurses, health care workers, CNAs, pharmacists…It defies logic to state that it’s a job killer.

“We still have groups of children that don’t receive coverage,” Woodall said, but if Medicaid were expanded, that would be ended.

Florida still has half a million uninsured children, ranking it third nationally in that regard. And the state currently faces a class-action lawsuit on the grounds that Medicaid children don’t get adequate care.

Actions ‘irresponsible’
Democratic Leader-designate Perry Thurston (D-Plantation) issued a scathing statement accusing Scott of “foot-dragging” and calling his actions “fiscally and morally irresponsible.”

“I believe it is a colossal abdication of Governor Scott’s responsibility to prematurely reject provisions of the Affordable Care Act…His recent repugnant and divisive remarks on the topic truly displays a lack of compassion, a lack of leadership and strikes me as a sickening political stunt at the expense of our state’s most vulnerable residents,” Thurston said.

“…The status quo only continues a costly reliance on hospital emergency rooms for treatment to the poor, which wastes resources and drives up costs for other consumers and businesses…Governor Scott’s defiance renders him incapable of recognizing that health insurance exchanges…embrace free market principles and promote personal responsibility by allowing consumers to comparison-shop in purchasing health coverage.

“…I call on Governor Scott to show leadership and end the political gamesmanship. It is time for Governor Scott to get to work and implement health care reform for Florida.”

Republicans cautious
While the Florida Legislature may not be ready to sign off on Scott’s decision, it’s not clear whether they’d have any choice. Scott has line item veto power over the budget, and controls the state health care agency that runs Medicaid.

House Speaker-designate Will Weatherford said the House would take a “rational, deliberative” approach to deciding whether to expand coverage.

Time to debate
State Sen. Joe Negron, R-Stuart and his chamber’s budget chief for health and human services, said he hopes Congress will “repeal Obamacare and start over from scratch with a better plan…

“But on the exchanges, in the event that Obamacare isn’t overturned, the state would have two options,” Negron said.

States have the choice of establishing and running the exchanges themselves or deferring to the feds to do so. The deadline is January 2013.

George E. Curry of the NNPA News Service and David Royse and Margie Menzel of the News Service of Florida contributed to this report.