State Sen. Aaron Bean, R-Jacksonville, says the debate over how exactly to implement the Affordable Care Act in Florida is far from over.
"There's going to be much more discussion as to what we should do next year as we watch other states," Bean said. "Maybe we can also clarify exactly what the federal government has in mind."
Bean served on the committee given the task of studying implementation of the Affordable Care Act, including the option of expanding Medicaid using federal funds. The legislature also had to decide whether the state would run its own health insurance marketplace, or let the federal government do it.
"The two questions we had this year are going to be staring us in the face as we launch the 2014 session as well," Bean said.
Florida decided right away to let the federal government set up and run the health insurance marketplace and opted out of Medicaid expansion, per se. The Senate came up with an alternative to traditional Medicaid that would have tapped the federal funds.
Bean was the architect of an alternative plan called Florida Health Choices Plus. It used no federal money and would have provided partial coverage to about 130,000, but even that didn't get Senate approval.
Bean, like all but one member of the state senate, voted for Sen. Joe Negron's Healthy Florida plan. That plan would have used federal funds --estimated at $51 billion over 10 years -- to buy private coverage for 1.1 million low-income uninsured. But the Republican-controlled House refused to sign on.
The plan relied on the cooperation from the federal government to allow it to draw down the federal dollars for a plan that's not Medicaid.
Bean says there was a chance the state could have been turned down in its request. He also says he "sort of" agrees with state Rep. Matt Hudson, R-Naples, who said Negron's plan was essentially Medicaid. Bean says that in the past, "If you took Medicaid money for a program and called it something else, they still treated it as if it were Medicaid."
Since the session ended without an expansion of health care for low-income Floridians, Bean has gotten some complaints from constituents.
"I've already been chewed out, I've been yelled at ... by a handful of folks that just disagree with my philosophy," Bean said.
While Gov. Rick Scott said he supported Medicaid, he has not called lawmakers back for a special session to reconsider their decision.