Florida is one of a handful of states rejecting grants from the federal health care reform law, a key strategy suggested in the literature provided at this year’s American Legislative Exchange Council conference, a conference many Florida legislators attended.
The Legislative Exchange Council (referred to as ALEC) is a conservative nonprofit made up of state legislators and business leaders that writes model bills and resolutions aimed at helping businesses and weakening government entities. The group meets somewhat clandestinely, but much of its legislation has crept into state legislatures all over the country. Florida’s GOP-led Legislature had a significant presence at the group’s August meeting in New Orleans.
Among the guides and literature circulating at the conference was a handbook called “The State Legislator’s Guide to Repealing ObamaCare” (.pdf).
The handbook lists “overburdened Medicaid programs, higher taxes, harmful individual mandates, job-killing employer mandates and [the] federal takeover of state insurance regulation” as reasons to repeal “ObamaCare.”
In a chapter titled “How Can You, As a State Legislator, Stop ObamaCare?” the handbook suggests that state legislators “reject ObamaCare discretionary grants that aid in the federal takeover of state health insurance regulation.”
According to the guide:
Through its grantmaking, the Patient Protection and Affordable Care Act conscripts states into enforcement arms of federal policy. While these grants may be attractive to cash-strapped states, federal funding comes with federal strings. It is unlikely that HHS will allow states that accept federal grants to ignore federal mandates. Many states have already refused federal grants designed by Congress to enforce or implement ObamaCare. In 2010, then-Minnesota Gov. Tim Pawlenty signed an executive order prohibiting state agencies from applying for ObamaCare-related discretionary grants.
Two states (Alaska, Minnesota) declined federal funding to help set up health insurance exchanges. Five states (Alaska, Wyoming, Iowa, Georgia, Minnesota) rejected federal “rate review” grants that would have required state insurance officials to enforce new federal rules against “unreasonable premium increases.” And only one state (Connecticut) has accepted federal dollars to expand its Medicaid population in advance of the 2014 deadline.
The Patient Protection and Affordable Care Act also offered states “free” federal money if they set up new, temporary high-risk insurance pools. (Many states had already enacted a high-risk pool on their own, but in an odd twist, Congress wanted those states to set up a second pool to undercut the ones already in place.) Twenty three states rejected these “free” funds, citing inadequate funding and other concerns. Instead, these states have let the federal government set up the new pools for their citizens.
The Florida Legislature has faced criticism lately for turning down federal grants while dealing with state spending cuts to health care services. Florida is one of only five states that has rejected a slew of federal grants from the Affordable Care Act. The Legislature turned down money for seniors in nursing homes, money for child abuse and neglect prevention, and money for community health centers — to name a few. However, the Legislature did approve funds for abstinence education.
State Sen. Nan Rich, D-Weston, has criticized the Legislature for accepting some funds while rejecting others. She called the move “hypocrisy.”
State Rep. Matt Hudson, R-Naples, who is the chair of the Health and Human Services appropriations subcommittee in the Florida House, was among the Florida legislators who attended the conference in New Orleans this year.
Hudson has been outspoken in defending the Legislature’s actions. He previously told the Independent that despite recent efforts from state agencies and the governor to recoup some of the grants lost, he will reject the funds once more.