Now that the federal healthcare reform law has passed U.S. Supreme Court muster, how might that affect the future of healthcare in Florida? That was the question a state insurance panel debated this week. Several predictions were tossed around: None of them good, and all of them uncertain.
The formal name for the panel is the Florida Health Insurance Advisory Board. State Insurance Commissioner Kevin McCarty, who chairs the group, said there was one overriding purpose for the meeting.
“Along with the rest of the country, we are still absorbing the impact of the Supreme Court ruling and we are gathered here today with a distinguished group of panelists to discuss a path forward for Florida.”
The U.S. Supreme Court ruling McCarty refers to is the one late last month, which upheld the essential constitutionality of the Affordable Care Act, also known as “Obamacare”. Among those giving their take at the meeting was Ed Haislmaier. He’s an analyst for the conservative-leaning Heritage Foundation and has been a very vocal Obamacare critic. But before telling board members what the law might do, Haislmaier noted there was still some uncertainty about whether the law itself would have much of a future after the November election.
“One scenario would be continued implementation of the statue if you get certain electoral outcomes. Another scenario if you get other electoral outcomes would be the repeal or dismantling and/or replacement of the statute," he said.
But Haislmaier believes one outcome is almost inevitable.
“One way or another, whether this stays or goes, there is a significant increase in the interest of employers in simply getting out of providing health benefits; a shift to a defined contribution of some kind.”
That would throw more of the cost of health care onto employees. Even if those employees continued to be covered by traditional health insurance, they could wind up paying more.
“According to the Congressional Budget Office in March of 2012, the CBO projected that private health premiums per enrollee will increase by 5.7% per year on average between 2012 and 2022," said Michael Garner, president and CEO of the Florida Association of Health Plans.
Garner said, the federal law will require insurers to pay about $ billion in fees after it fully kicks in in 2014. That figure could nearly double to $14 billion dollars by 2018. But even so, Garner stressed there are many moving parts and many unknowns, “Like many individuals and many groups, we still are trying to ultimately determine what the full impact of the Affordable Care Act Supreme Court decision is on Florida.”
Adding to the uncertainty, Florida is one of a handful of states that are not setting up health exchanges to cover those whose employers don’t provide coverage. The federal government will have to step in to run the program in Florida and those other states. Florida is also refusing to expand its Medicaid program for low-income people, even though the federal government will be picking up nearly all of the initial cost of that expansion. That concerns Brian Desloge. He’s a Leon County Commissioner who also owns a medical equipment supply company.
“It’s a complex system. And in the Medicaid case, you’ve got people moving from county to county to county to get care. If someone gets sick in Leon County and goes down to Shands for care and then has further complications and checks into a nursing home in Ocala, where’s their home of residence and if the county’s picking up some of this, which county is responsible?”
Desloge, who describes himself as a “right-of-center-Republican”, even questions his party’s call to repeal and replace federal healthcare reform.
“I personally am not wild about it, although I haven’t seen alternatives offered that really grab me or make me feel comfortable that there’s a better plan being proposed," he said.
So, for now, the future of healthcare in Florida, and across the country, seems to hinge on what happens November 6th.