The fight over the future of Healthcare in Florida is not over, despite a U.S. Supreme Court ruling reaffirming the Affordable Care Act. The Court has upheld subsidies for nearly nine million Americans who purchased health insurance on the federal government’s insurance exchange. Some hope the court’s latest ruling could push states like Florida, to fully implement the law.
More than a million Floridians get federal subsidies to purchase insurance on the federal government’s healthcare.gov’s website. Florida is one of 34 states that use the system. This is the first time 25-year-old Andrew Beckner has had health insurance.
“I would go to the doctor when I was really, really sick or if I needed something. Other than that, I definitely wouldn’t go. It was too much money for me to afford at the time," he says.
Beckner knew about the Affordable Care act, and the healthcare.gov website, but hadn’t sign up. But last year, he was in a car accident. A bad one.
“Well, before that, I’d tried to sign up. It was confusing so I didn’t put much effort into it. I guess I was sort of used to not having insurance. But a year ago I got into a car accident. A life-threatening car accident. It really messed me up financially, it prevented me from doing anything for months. Once that happened I realized I needed to take my health seriously, and I made it a point to sign up.”
Beckner gets a subsidy to bring his insurance costs down. And he’s paying about $50 a month. And he’s been sharing his story with his friends and his family.
“My family is very conservative, and they raised me very conservative. I was pleased to show them it actually works and I’m not crazy, it’s not some liberal, socialist thing that will bankrupt the country. And once I showed them how it works, I think it was kind of eye-opening for them.”
And he's pleased with the U.S. Supreme Court's recent ruling.
“It’s been working out great for me since I got it in February and I’m so excited to continue to keep my healthcare.”
“It’s a huge victory for the consumers in Florida, 1.4 million of them who will continue to have access to high quality, affordable healthcare coverage," Florida Chain Policy Director Laura Brennaman says.
She’s praising the U.S. Supreme Court for upholding the subsidies in the case of King V. Burwell. The case centered on whether the subsidies, used by up to nine million Americans, were legal. Plaintiffs in the case argued the affordable care act, those subsides were only for use on state-exchanges. But writing for the 6-3 Majority opinion, Chief Justice John Roberts says, while that may be, there’s a larger point.
“Congress passed the Affordable Care Act to improve health insurance markets, not to destroy them. If at all possible, we must interpret the act as consistent with the former, and avoids the latter.”
Joan Alker is a Medicaid expert with Georgetown University. She says, "there’s no question there are very deep divisions within the Republican Party on this issue and I think a lot of it stems from some of the fervent opposition to this president.”
The ruling comes on the heels of a nasty fight over the future of healthcare in Florida. A plan by the state Senate would have set up a state exchange, and allowed people who fall into what’s called the Medicaid coverage gap, to use federal expansion money to purchase private plans. The Florida House and Governor Rick Scott opposed the move. And many Florida politicians saw a potential ruling against King V. Burwell, as a way to get a Medicaid expansion through the Florida legislature.
The reasoning was, if Floridians lost their subsidies, it would increase pressure on Florida politicians to do something. Alker says there’s some truth to that. But the ruling also keeps other options for a Medicaid expansion open.
“It’s interesting though. I think for states like Florida that have not moved ahead, one of the very live options is to consider putting Medicaid beneficiaries—particularly those above the poverty level—into the federal exchange….and this ruling preserves that option for them," she says.
But now that the court has ruled, that pressure is easing. Still, Florida’s healthcare battles are far from over:
"We need to move to fulfill the promise of health reform. I’m hopeful that our representatives in Tallahassee will pay heed to this decision and move to close that gap," Florida Chain's Brennaman says.
One of those fights continues to be over a separate program that reimburses hospitals for treating uninsured patients. Governor Rick Scott has dropped a lawsuit over funding for the Low-Income Pool after finalizing an agreement that starts phasing out the program. This year Florida saw a billion dollar cut in the funding, and next year, the dollars decrease even more. Its opening larger and larger holes in the state budget—one supporters of a Medicaid expansion say will have to be addressed eventually.