As expected, Florida missed a Friday deadline to sign up for a partnership with President Barack Obama’s administration to operate a health exchange, an online marketplace that is required for each state under the 2010 federal health care law.
U.S. Health and Human Services Secretary Kathleen Sebelius gave states until midnight Friday to let her know if they wanted to participate with the federal government in joint operation of the online shopping centers where people can purchase health insurance and see if they qualify for federal benefits, including Medicaid. Florida had already missed the deadline for operating its exchange on its own.
Florida’s inaction means the U.S. government will run the state’s exchange for at least its first year. States can later opt to run their exchanges or partner with the federal government.
The law requires all exchanges to be up-and-running on Oct. 1, which will allow individuals and small businesses to compare prices and buy insurance from qualified insurance plans that will go into effect Jan. 1, 2014. They can also see if they are eligible for tax credits to help pay for the insurance.
“Florida, and several other states, did not submit a letter to the Secretary of Health and Human Services to indicate an intention to operate a State Based Exchange for health care coverage in calendar year 2014,” said Katie Betta, spokeswoman for Florida Senate President Don Gaetz, R-Niceville. “Under (the law), the federal government will provide an exchange for states that do not elect to operate one.”
Although the federal law was enacted in 2010, Gov. Rick Scott and Florida’s legislative leaders, all Republicans opposed to the law, did not allow state workers to take the actions necessary to implement it in the state, instead banking on the U.S. Supreme Court to overturn it or a Mitt Romney election win to lead to its repeal. When neither of those things happened, state leaders began acknowledging the law but have since said the federal government has not provided them the necessary information they need to make decisions.
“We continue to be concerned about the many unknowns impacting the cost of operating an exchange, and simply do not have enough information to make a decision about running one at this time,” said Scott’s communications director, Melissa Sellers. “Gov. Scott is also working with federal health officials in Washington to approve the state’s Statewide Medicaid Managed Care waiver, which will give the state more flexibility to improve the cost, quality and access of health-care services.”
Betta said for the Senate, “So moving forward, while we await more information from the federal government, we have time to consider what, if any, action related to the operation of an exchange might be in the best interest of the state of Florida.”
Florida lawmakers this year have held a series of meetings on the exchanges along with the expansion of Medicaid and could reach a decision during the two-month legislative session that begins on March 3.
The Health and Human Services Department said Friday it will not issue a release about the exchanges until Tuesday because Friday’s deadline didn’t end until midnight and Monday is a federal holiday for Presidents Day.
But as of Friday, 17 states and the District of Columbia had been approved to operate their own exchanges. Three states – Arkansas, Delaware and Illinois – had conditional approval for a partnership.
In partnerships, states are allowed to approve which insurers can participate on the state’s exchange and to establish the minimum benefits that insurers must offer. Partnerships also give the state control of consumer assistance programs such as hot lines. The federal government, which prefers that states participate, is still responsible for running and marketing the website and determining eligibility for federal subsidies.