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Florida to miss exchange deadline

Leon County Judge John Cooper on June 30, 2022, in a screen grab from The Florida Channel.
The Florida Channel
Leon County Judge John Cooper on June 30, 2022, in a screen grab from The Florida Channel.

Florida Gov. Rick Scott and Republican legislative leaders counted on Mitt Romney to win the election and repeal what they call “ObamaCare.” That didn't happen.

Now, the state’s about to miss an important deadline in implementation of the Patient Protection and Affordable Care Act.

On Nov. 16, states are supposed to turn in the applications and blueprints for their health insurance exchanges. The exchanges are virtual shopping malls where the uninsured are supposed to go a year from now to sign up for health coverage for 2014.

Florida won’t make the Nov. 16 deadline for a blueprint. It hasn't even tried.

'Behind the 8-ball'

In the 2 1/2 years since the Affordable Care Act was signed into law, the state has done virtually nothing to implement it, on orders from the Opponent-in-Chief, Gov. Scott. (On Wednesday, theSarasota Herald-Tribunereported, Scott restated his opposition to expanding Medicaid or setting up an exchange, saying they would cost too much.)

Given that Florida has around 4 million uninsured, patient advocates aren't happy about the delays. Bob Levy, a lobbyist for hospitals and the Florida Nurses Association, said Scott's opposition to the ACA has cost the state far too much.

"We have turned back literally hundreds of millions of dollars that have been sent as part of the Act," Levy said. Other states, even those that opposed the ACA, accepted grants and started planning for implementation, he said. Because Florida didn't, "we're behind the 8-ball today."

If states don’t create an exchange, the federal government will do it for them. But the result might not be one that Florida officials like.

On the other hand, it would cost Florida a lot to set up and operate a state-run exchange, said incoming Senate President Don Gaetz. "That can run into many millions of dollars," he said.

A third way: 'partnership'

Gaetz said staff members for the legislature and executive branch have been discussing a third option: a "partnership exchange." This would involve recruiting a private organization that already has built an online exchange.

"We might use one of the existing organizations-- FL Healthy Kids, for example, that some people believe might be able to qualify as an exchange if the federal government agrees,“ Gaetz said.

Florida Healthy Kids is a non-profit group that offers working families affordable coverage for their children. Another possibility that has been discussed is Florida Health Choices, which offers an online exchange to small employers. It will open for shopping on Jan. 1, said Executive Director Rose Naff.

Nothing will happen until March

Even if Gov. Rick Scott had a change of heart and wanted to send in an application, the Legislature hasn't given him the authority. And neither the House nor the Senate sees any need to rush back to Tallahassee to authorize it.

Rep. Matt Hudson, the Florida House health care chief, said, "I know there are deadlines that are certainly looming, but those deadlines can come and go, and that doesn't preclude us from doing anything."

Hudson said the federal government has not yet come up with complete guidelines for the exchanges yet, anyway. "We will not make any decisions until the legislative session in March," he said.

Although Florida is one of the largest states in the nation, its Legislature meets just two months a year.

--Health News Florida: Journalism for a Healthy State, is a project of WUSF Public Media. You can hear it on 89.7 in Tampa or go online to

Carol Gentry, founder and special correspondent of Health News Florida, has four decades of experience covering health finance and policy, with an emphasis on consumer education and protection.