A proposed constitutional amendment seeking to exempt Floridians from federal health insurance mandates became the first measure to pass a Senate committee Wednesday, and will likely be among the first bills to pass during this springâs session. But the discussion has emerged about how Florida already has a path to exempting itself from the federal plan.
Business groups and tea party activists were on hand to support the Senate measure, a slightly retooled version of Amendment 9, which was struck from this yearâs ballot by the Florida Supreme Court.
State Sen. Don Gaetz, R-Niceville, who joined the majority on a 9-2 vote before the Senate Health Regulation Committee, described the measure as a ârifle shotâ aimed at the most grievous portion of the health care reform bill passed last year by Congress: the mandate requiring individuals to pay penalties if they donât buy health insurance.
Speaking in opposition, Rich Templin of the AFL-CIO of Florida pointed out that there is already a way for Florida to gain a statewide exemption from the individual mandate. Ezra Klein explains:
This morning, Sens. Ron Wyden (D-Ore.) and Scott Brown (R-Mass.) introduced the âEmpowering States to Innovate Act.â The legislation would allow states to develop their own health-care reform proposals that would preempt the federal governmentâs effort. If a state can think of a plan that covers as many people, with as comprehensive insurance, at as low a cost, without adding to the deficit, the state can get the money the federal government wouldâve given it for health-care reform but be freed from the individual mandate, the exchanges, the insurance requirements, the subsidy scheme and pretty much everything else in the bill.
Wyden, with the help of Sen. Bernie Sanders (I-Vt.), was able to build a version of this exemption into the original health-care reform bill, but for various reasons, was forced to accept a starting date of 2017 â three years after the Patient Protection and Affordable Care Act goes into effect. The Wyden/Brown legislation would allow states to propose their alternatives now and start implementing them in 2014, rather than wasting time and money setting up a federal structure that they donât plan to use.
That idea, Gaetz responded, would still require Florida to create âa state version of ObamaCare.â As Ross Douthat explains:
In theory, itâs an excellent idea, but the devil is in the details â and particularly the requirement that a state plan would need to subsidize insurance thatâs âas comprehensiveâ as the kind of coverage mandated under Obamacare. This seems to stack the deck against precisely the sort of consumer-directed, market-friendly systems that more conservative states would try to build, creating the kind of âfederalism for me, but not for theeâ scenario that Reihan Salam outlines.
So while the exemptions mentioned by Templin would give states more wiggle room in the ways they implement the reforms touted by President Obama, that doesnât satisfy Republicans looking to  ârepeal and replaceâ the Patient Protection and Affordable Care Act.