June 26, 2015

Burwell decision secures subsidies, but feud continues in Florida over health care

Gov. Rick Scott and the legislative opponents to the Affordable Care Act dodged a bullet Thursday when the U.S. Supreme Court upheld the federal health insurance subsidies, but it did little to narrow the divide between Republicans over how to handle Florida’s uninsured.

The ruling reduces the pressure on state leaders to create a state exchange to cover the 1.3 million low- and middle-income Floridians who now rely on the federal program for health insurance. But it leaves unanswered the question of how Florida will handle the loss of $400 million federal Low Income Pool money used to reimburse hospitals and health care providers who provide charity care to the uninsured.

After a bitter and divisive legislative session that led to a special budget session ending last week, lawmakers must return in January to craft a new budget for 2016-17 that addresses the loss of the LIP funds. The federal government confirmed this week that it would limit Florida’s LIP money to $1 billion to help cover the cost of the uninsured not covered under Obamacare, for the 2015-16 budget year. But it also said the state’s LIP money would be limited to only $600 million in 2016-17.

That has prompted Republicans in the Florida Senate to renew calls for the state to create an alternative, privately run plan to draw down federal money to cover an estimated 800,000 uninsured Floridians. Florida was among the 34 states that allowed the federal government to run the insurance marketplace, known as exchanges, that allow eligible Floridians to shop for individual health plans.

But thousands of low-income adults who would be eligible for Medicaid under expansion remain in the “coverage gap.”

Scott and the Republican leaders in the House opposed the Senate’s efforts to create the plan this year. They argued it would prop up a “broken” Medicaid system, expand the federal deficit and hurt taxpayers.

The issue deeply divided the two chambers, as Scott and House leaders accused several senators, including Senate President Andy Gardiner, R-Orlando, who works for an Orlando hospital, of using his office to advocate for his industry.

On Thursday, comment from both sides indicated the feuding is likely to continue.

More here.

June 25, 2015

Scott and Bondi react to Burwell ruling: Obamacare is still a bad law

Gov. Rick Scott and Attorney General Pam Bondi did not have much to say about the U.S. Supreme Court ruling today upholding the Affordable Care Act subsidies to states that rely on the federal exchange but instead steered their focus to the continued opposition to the underlying law. 

 "The Affordable Care Act continues to be the most heavy handed federal health care law in our nation’s history, and today’s decision in the King v. Burwell case does nothing to alleviate the harms the law will continue to cause,'' Bondi said in a statement.

Asked to comment at a veterans event in St. Augustine Scott responded, "It's a bad law. It was supposed to reduce health care costs and health care costs have gone up,'' he said, according to his spokeswoman Geri Bustamante.

He also noted that state-run exchanges "are collapsing across the country because it’s costing more than people thought." He continues to hope for the law's repeal, she said. 

Gov. Rick Scott's stalled promise about fighting for Obamacare repeal

Gov. Rick Scott's promise to fight to repeal the federal health care law was dealt another blow June 25 when the U.S. Supreme Court ruled 6-3 to uphold subsidies for consumers who purchase insurance in the federal exchange as part of the Affordable Care Act.

That means that millions of Americans, including 1.3 million in Florida, can keep their subsidies to help them afford insurance. Since Scott and the state Legislature did not want to establish its own insurance exchange under the law, the state is one of 34 that relies on the federally-run marketplace at HealthCare.gov.

Scott, a former health care company executive, began his fight against the Affordable Care Act before he was a candidate in Florida.

In 2009, Scott spent $5 million of his own money to form Conservatives for Patients' Rights, a group that fought Obama's original health care proposal.

In 2010, Scott said he would join efforts to repeal the health care law, including supporting a constitutional amendment that "prohibits the federal government from imposing President Obama's individual mandate, to protect Floridians' freedom to control their health care choices."

At PolitiFact Florida we have been tracking dozens of Scott's promises, including his one to fight the Affordable Care Act, since he won his first campaign in 2010 and was re-elected in 2014. And we have fact-checked many claims by Scott related to the Affordable Care Act.

Turn to PolitiFact Florida for the rest of our promise update.

As the Supreme Court rules on Obamacare, a look at PolitiFact's most fact-checked topic of health care

In a highly anticipated ruling on the health care law, the U.S. Supreme Court ruled Thursday that critical subsidies for health insurance are allowed under the Affordable Care Act.

The ruling in King vs. Burwell means that millions of Americans will continue to have access to subsidized health insurance on federal insurance exchanges like healthcare.gov.

The 6-3 decision included affirmative votes from Chief Justice John Roberts, as well as Justice Anthony Kennedy, who often wields the court’s key swing vote.

PolitiFact has been fact-checking health care since 2007, from ideas on the campaign trail, to the drafting of legislation in 2009, to the implementation of the Affordable Care Act in 2010. We have published just over 1,300 fact-checks on health care, our most fact-checked topic.

Browse all of our fact-checks on health care, including our 2013 report, 16 myths about health care, and our PolitiFact Sheet that previewed the King vs. Burwell ruling.

In Florida, we have fact-checked many claims by Gov. Rick Scott related to the Affordable Care Act.

We have also fact-checked health care claims by Gov. Jeb Bush, U.S. Sen. Marco Rubio, Attorney General Pam Bondi, U.S. Sen. Bill Nelson and U.S. Rep. Debbie Wasserman Schultz here and here.

--with Angie Drobnic Holan

Scott withdraws lawsuit on LIP, says it was 'essential' to getting feds to continue subsidy

UPDATE: Gov. Rick Scott announced Thursday he was dropping the lawsuit filed in federal court in April, accusing the federal government of attempting to use the Low Income Pool funding to "coerce" the state into expanding Medicaid under the Affordable Care Act.

The cost to taxpayers for the legal challenge: $175,000, according a contract completed Thursday with the Washington, D.C., law firm Bancroft Associates, which represented Scott in Florida's challenge to the Affordable Care Act.  Download EXD053 - Bancroft_For Legal (3)

Scott all but conceded the lawsuit was moot on Tuesday when he signed the budget and accepted the terms of the LIP funding model developed by legislators and his agency staff.

But he waited until Thursay to announce he officially dropping the lawsuit -- an hour after the U.S. Supreme Court ruled in King v. Burwell to uphold subsidies for the uninsured in states like Florida that have established a federal insurance exchange. Scott had supported the King lawsuit and wants to see the Affordable Care Act repealed. 

In a statement, Scott said his lawsuit challenging LIP "was essential to making Obama continue LIP funding," but he cited no facts to back up that claim. 

The federal Centers for Medicare and Medicaid told the state last year that the funding for LIP was going to decline as it was phasing out subsidies to states that reimburse hospitals for charity care, but it never claimed it would eliminate all funding.

Continue reading "Scott withdraws lawsuit on LIP, says it was 'essential' to getting feds to continue subsidy" »

Gardiner calls Burwell ruling 'welcome news'; Oliva says he's 'gravely concerned'

Florida Senate President Andy Gardiner called the ruling today by the U.S. Supreme Court upholding health insurance subsidies on the federal health care exchange ''welcome news for the 1.3 million Floridians who currently receive subsidies on the federal exchange."

But in the Florida House, where Republican leaders there intensely oppose accepting any federal money tied to expanding Medicaid for the uninsured, the reception was the opposite.

"Gravely concerned,'' said Rep. Jose Oliva, R-Miami, who is slated to become House speaker in 2018, in a text to the Herald/Times. "Concerned for the future as our constitutional guardians rely less and less on our hallowed charter and more on the politics and practicality of the moment."

Rep. Mia Jones of Jacksonville, the Democrat's point person on health care in the House, said she was relieved by the decision.

 “I’m especially happy with the court’s ruling because, if the outcome would have been different, Republican leadership in Florida – particularly Gov. Rick Scott – had done nothing to prepare for such an outcome,'' she said in a statement. "Even though that negligence is fact, I’m glad it won’t harm anyone.”

Continue reading "Gardiner calls Burwell ruling 'welcome news'; Oliva says he's 'gravely concerned'" »

1.3M Floridians to keep Obamacare subsidies after SCOTUS ruling

via @dchangmiami @chabelih

The U.S. Supreme Court ruled Thursday by a 6-3 vote that more than 6 million Americans, including 1.3 million Floridians, can continue to receive subsidies under the Affordable Care Act to buy health insurance through the federally run exchange at HealthCare.gov.

Ruling in the case of King v. Burwell, the Supreme Court upheld the Obama administration’s interpretation of the health law that allows billions of dollars in health insurance subsidies — including an estimated $389 million a month for Florida residents — to be distributed in the 34 states where the federal government operates the insurance exchange because the state decided against it. 

Writing for the majority, Chief Justice John Roberts acknowledged that the challengers' "arguments about the plain meaning . . . are strong."

But, he noted: "Congress passed the Affordable Care Act to improve health insurance markets, not to estroy them."

From the majority opinion: "In this instance, the context and structure of the Act compel us to depart from what would otherwise be the most natural reading of the pertinent statutory phrase."

Dissenting were Justices Antonin Scalia, who read his opinion from the bench, according to a report from SCOTUSblog.com, Clarence Thomas and Samuel Alito. Scalia was critical of the health law in his reading from the bench.

From Scalia's dissent: "We should start calling this law SCOTUScare."

More here.

Florida politicians react to SCOTUS ruling on Obamacare

@PatriciaMazzei

The U.S. Supreme Court on Thursday upheld subsidies for the Affordable Care Act, allowing Obamacare to continue as it exists today. Here's the reaction from Florida politicians, updated as they come in:

U.S. Sen. Marco Rubio, R-Florida (also 2016 presidential candidate)

I disagree with the Court’s ruling and believe they have once again erred in trying to correct the mistakes made by President Obama and Congress in forcing Obamacare on the American people.

Despite the Court’s decision, ObamaCare is still a bad law that is having a negative impact on our country and on millions of Americans. I remain committed to repealing this bad law and replacing it with my consumer-centered plan that puts patients and families back in control of their health care decisions. We need Consumer Care, not ObamaCare.

Former Gov. Jeb Bush, 2016 Republican presidential candidate (also released a video statement)

I am disappointed by today’s Supreme Court ruling in the King v. Burwell case. But this decision is not the end of the fight against Obamacare.

This fatally-flawed law imposes job-killing mandates, causes spending in Washington to skyrocket by $1.7 trillion, raises taxes by $1 trillion and drives up health care costs.  Instead of fixing our health care system, it made the problems worse.

As President of the United States, I would make fixing our broken health care system one of my top priorities.   I will work with Congress to repeal and replace this flawed law with conservative reforms that empower consumers with more choices and control over their health care decisions.

Here is what I believe:  We need to put patients in charge of their own decisions and health care reform should actually lower costs.  Entrepreneurs should be freed to lower costs and improve access to care – just like American ingenuity does in other sectors of the economy. 

Americans deserve leadership that can actually fix our broken health care system, and they are certainly not getting it now from Washington, DC.  

Continue reading "Florida politicians react to SCOTUS ruling on Obamacare" »

June 24, 2015

As agreement puts end to LIP debate -- for now -- it also means losses for local hospitals

@MaryEllenKlas @dchangmiami

The tumultuous debate over the future of healthcare funding for the poor came to a quiet end Tuesday as the governor signed into law a budget that includes $1 billion in federal funds to pay for charity care and raise Medicaid rates at Florida hospitals.

In a letter to state officials, the federal Centers for Medicare and Medicaid Services (CMS) said they have “agreed in principle” to a Florida plan for distribution of the Low Income Pool (LIP) funds that pay for hospital care for Medicaid beneficiaries and the low-income uninsured. The plan also calls for paying higher Medicaid rates to hospitals, particularly those that care for large numbers of uninsured patients.

State lawmakers had to redesign the LIP program and raise Medicaid reimbursement rates because the federal government reduced LIP money for Florida by $1.2 billion for the coming year, which led to a budget impasse between the House and Senate this spring and then to a special session on the budget that ended last week.

The Senate, siding with business groups, hospitals and health insurers across the state, wanted to offset the loss of LIP money by creating a privately-run insurance exchange to draw down federal Medicaid expansion money available under the Affordable Care Act. But the House rejected the plan, resulting in the budget standoff. 

Government regulators agreed to extend Florida’s 9-year-old LIP program, but capped spending for the coming year at $1 billion in combined federal and state funds. Under the agreement, combined LIP spending will be capped at $608 million the following year, starting in July 2016.

For this year’s budget, legislators decided to inject $400 million in state funds, which will draw down $600 million in federal matching funds, to raise Medicaid rates for hospitals — offsetting the reduction in LIP funds with higher rates.

Continue reading "As agreement puts end to LIP debate -- for now -- it also means losses for local hospitals" »

June 23, 2015

What Jeb Bush said in Miami this month about SCOTUS and Obamacare

@PatriciaMazzei

When he spoke to reporters in Miami on June 5, Jeb Bush was asked what government should do if the U.S. Supreme Court rules subsidies for the Affordable Care Act unconstitutional (a decision is due by Monday).

Here's what Bush said:

I think Congress ought to proactively unite behind an alternative to the status quo that would allow for a continuation -- as proposed, for example, by Sen. [Ron] Johnson [R-Wisconsin], or a variation of that -- where we would extend this out so there's not big disruption. But also give states the power to change Obamacare. In Florida it might mean less mandates -- no employer mandate, no employee mandate -- a high-deductible, lower-cost insurance that’s focused on catastrophic coverage in an exchange that's not coercive. So I think this is the opportunity for Republicans to not just talk about how bad Obamacare is -- which it is -- but also to unite behind an alternative. And Congress would have to do this. If not, the governor is stuck, and the Legislature is stuck, in a precarious position.