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Sebelius vs. Scott: Public 'at Risk'

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 officials are callous and secretive, willing to keep information from citizens that could save their lives, according to the Obama administration's top health official.  Meanwhile, those same officials accuse the administration of placing the public's safety at risk.

It's just another day in Florida as the Affordable Care Act's meatiest parts head for implementation Jan. 1. While other Republican-led states have also denounced Obamacare, Florida's intensity in the attack has made the state an "outlier," according to the New York Times.

On Tuesday, Gov. Rick Scott and other state officials ramped up their attack on the federal online Marketplace and the "Navigators" who will help the uninsured use it to enroll in a health plan for 2014.

In a letterto Congressional leaders, he asked them to investigate the security of the online enrollment systems after a state-based enrollment system in Minnesota suffered a data breach because of human error.

Meanwhile Kathleen Sebelius, secretary of the US Department of Health and Human Services, said on a trip to Miami on Tuesday -- her third to Florida in a week --that state officials are "keeping information from people" in a political effort to foil the enrollment effort, the Miami Herald reports.

Florida citizens "have a right to know what the law is and what benefits they may be entitled to receive," she said. "It’s unfortunate that keeping information from people seems to be something of a pattern here in this state."

The public, caught in the middle, remains largely clueless about what is in the Affordable Care Act and whether it affects them, surveys show. NPR's Greg Allensays that when an Enroll America staffer visited a Miami church and asked how many knew about the law, few hands went up.

As navigators prepare for Oct. 1, the day they can begin signing people up for health plans, Scott's administration has raised a series of obstacles, as Health News Floridareported last week. The state health department sent out a directive saying navigators would not be allowed to use any of its offices for outreach and enrolling.

"It's unfortunate that scare tactics are being used which may actually prevent people from getting healthy in the first place," Sebelius said.

Florida has an estimated 3.8 million uninsured, and millions more who are underinsured, according to a new Commonwealth Fund study released Wednesday.

Among the ways that Florida has tried to impede Obamacare:

--It led the court challenge on the constitutionality of the Patient Protection and Affordable Care Act in 2010 soon after President Barack Obama signed it into law. Attorney General Pam Bondi made it one of her high-profile issues, becoming a regular guest on Fox News to attack it.

--After the Supreme Court ruled the law was constitutional, the Florida Legislature told state agencies not to implement it because lawmakers felt sure the Republican party Presidential candidate, Mitt Romney, would win the election in 2012. At that point, the law could be repealed.

--After Romney lost the election, many expected Florida to follow the lead of other states and begin implementing the law. Instead, the governor and legislature pressured the agencies not to apply for grants related to the law; some agencies had to give back grants they had already won.

--The Legislature this year voted against Florida having its own electronic marketplace for health-plan shopping, even though the state had already spent five years and several million dollars building an online shopping site, Florida Health Choices, that has yet to be used. That put state lawmakers who frequently complained about the federal government grabbing too much power in the strange position of shoving more power at the feds.

--After months of hearings and negotiations, the Florida Senate came up with a compromise plan on Medicaid expansion that would accomplish several things: Reduce the number of uninsured Floridians by about 1 million by using federal funds,  save millions of state dollars now being spent on the uninsured, and continue privatization of the Medicaid program, already well under way. But the House said no.

--The Legislature voted to strip the Insurance Commissioner's authority to regulate health premiums for two years.

--Insurance Commissioner Kevin McCarty issued a report that predicted health premiums in Florida's  individual market would soar 30 to 40 percent, thereby producing scandalous headlines. Later, others would note that the figure failed to make adjustments for the tax credits most of those shopping in that market would qualify for. He also failed to mention that the sector he was describing accounts for only 5 percent of policies.

--With the knowledge of Gov. Rick Scott, the state Department of Health ordered the health department directors around the state to bar "Navigators" -- enrollment counselors helping the uninsured sign up for health plans on the Affordable Care Act Marketplace starting Oct. 1. A quick-thinking director, Dr. Claude Dharamraj, was able to get around the orderby pointing out to her superiors at DOH that the state agency did not own the buildings; the county did. But by that time, most of the newspapers in the state and a number of others around the country were calling Florida officials mean-spirited for trying to block the uninsured from enrollment.

--Scott sounded an alarm at a Cabinet meeting about the federal online Marketplace's security, suggesting that the Obama administration wanted to amass a giant database of Floridians' health information. He also warns that there are security risks from both the machinery and the Navigators aiding in enrollment.

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.