Speaking at an event in Miami today, Health and Human Services Secretary Kathleen Sebelius said that, despite the Florida government’s refusal to implement the Affordable Care Act, the state must eventually take part in all aspects of the law.

In about nine months, as required by federal law, all states will have to prove to the federal government that they are on their way to creating a state health insurance exchange (state-operated health insurance databases that allow citizens to shop around for insurance) that will be operational by 2014. All of the plans must meet the same requirements, such as offering coverage to people with pre-existing conditions and providing coverage for services like family planning.

State policymakers, however, have done nothing to even begin planning for the creation of the exchanges. As the 2012 legislative session wrapped up earlier this month, not a single meeting was held to even discuss the possibility of the state attempting to create an exchange.

Florida is currently leading the legal challenge to the Affordable Care Act, which will be heard in the U.S. Supreme Court in less than a week.

Kaiser Health News reported back in December that Florida remains one of three states in which policymakers claim that they “flat out… won’t establish exchanges of their own.” Gov. Rick Scott has said publicly that he does not believe the health care reform is “the law of the land,” and will not implement it until the Supreme Court decides to uphold the law.

Despite the stalling, Sebelius tells the Florida Independent that Florida will have a health exchange program.

“What we have said to states is: ‘[What] we need to know at the beginning of 2013 is whether or not you intend to do this,’” she explains. “We are responsible in the law for putting together a federal exchange for Floridians.”

State lawmakers have been warned that if they fail to follow the law, the federal government will step in and create an exchange for them.

“They will have a deadline to meet if they choose not to move ahead with the state-based exchange,” Sebelius says. “We will launch an enrollment process and a federal exchange for the citizens of Florida.”

“We think some states will be fully ready to go by 2014,” she continues. “Other states will be in what we call a ‘partnership,’ which means we will run part of the plan and they will run part of the plan. And there may be a third category, unfortunately, that says, ‘we are not going to do a thing,’ and in that case, if they cede their authority to us, we will make sure citizens of Florida have the availability.”

Sebelius also says that the state is disregarding the health needs of its citizens by rejecting federal health grants that are allocated through the Affordable Care Act. The state has turned away millions of dollars allocated to them by the state, some of which would have gone toward child abuse prevention.

“What they are doing is saying that the federal dollars, where Florida pays taxes into,” she explains, “that they will not use [it] to benefit the health of these citizens.”

Sebelius says that, eventually, Florida will be able to receive federal health grants.

“When the exchanges are up and running we can put those services together– but we cannot put the services together that they are turning down,” she says, adding that, “unfortunately, it’s the most underserved Floridians that are the victims of that choice.”

The state’s rejection of countless health grants has drawn fire from elected Democrats in the state, who have voiced their frustration with the GOP-led Legislature’s attitude toward the law.

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