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GOP, DEM LEADERS DIVIDED ON OBAMACARE DECISIONS

By JIM SAUNDERS
THE NEWS SERVICE OF FLORIDA
images GOP, DEM LEADERS DIVIDED ON OBAMACARE DECISIONS

THE CAPITAL, TALLAHASSEE, January 30, 2013……Despite criticism from top Democrats that the state has been “dragging its feet,” House and Senate Republican leaders said Wednesday they would be deliberate in deciding how to handle key parts of the federal Affordable Care Act.

Speaking to reporters and editors from across the state, House Minority Leader Perry Thurston and Senate Minority Leader Chris Smith, both Fort Lauderdale area Democrats, said Florida needs to move forward with a major Medicaid expansion under the law better known as “Obamacare.” While Washington has promised to pay at least 90 percent of the expansion costs in the coming years, Gov. Rick Scott and GOP legislative leaders have not committed to the state taking part.

“We’re not talking about turning down money for a rail system,” Thurston said, referring to an earlier decision by Scott to reject federal funding for high-speed rail. “We’re talking about saving lives.”

But Senate President Don Gaetz, R-Niceville, and House Speaker Will Weatherford, R-Wesley Chapel, said the federal government gave states an “all or nothing” choice on the Medicaid expansion, which involves making coverage available to more people based on income levels. Gaetz and Weatherford indicated they would like flexibility to determine who could become newly eligible for Medicaid, but the Obama administration says states will have to fully expand eligibility to be able to tap into the federal money.

Gaetz said, for example, he wishes the state could draw a distinction between a low-income working family that needs health coverage and somebody else who chooses to “sit on the couch” and not work. The House and Senate have formed select committees that will make recommendations about issues such as whether to expand Medicaid.

“It will be a decision based on principle and not on politics,” said Weatherford, who appeared with Gaetz at an annual gathering hosted by the Associated Press in advance of the legislative session.

The Affordable Care Act, which President Obama and congressional Democrats approved in 2010, has been one of the country’s most-volatile political issues in recent years. Florida Republican leaders fought the law in court and refused for more than two years to take steps to implement it.

But that stance started to soften last year after the U.S. Supreme Court upheld most of the law and Obama won re-election. The state is now faced with decisions about issues such as whether to expand Medicaid eligibility and whether to eventually take part in running a health-insurance exchange, a type of online marketplace where people will be able buy coverage.

Weatherford said the Medicaid expansion, which is optional for the state, will be the most heavily lobbied issue stemming from the Affordable Care Act. For instance, hospitals have a stake in the issue because the Medicaid expansion could help reduce the amount of uncompensated care in the health-care system.

Scott, who also appeared at Wednesday’s Associated Press gathering, did not offer a clear position when asked about the Medicaid expansion. He discussed the issue recently with U.S. Health and Human Services Secretary Kathleen Sebelius — but also faced widespread criticism for using estimates that critics said inflated the state’s possible costs for the Medicaid expansion.

Thurston, Smith and other Democratic lawmakers are pushing for the Medicaid expansion and publicly criticizing the GOP’s handling of the Affordable Care Act. Thurston said the state has been “dragging its feet on the implementation” and that Republican leaders now say they need more time to deal with the law.

“We’ve come a long way to get back to where we started,” Smith said.

But Gaetz said lawmakers will carefully examine the law before deciding how to move forward. Along with the Medicaid expansion and the exchange issue, they also are trying to sort out a thicket of insurance-regulation issues.

“We’re going to measure twice and cut once,” Gaetz said.

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