TALLAHASSEE, Fla. (AP) — Gov. Rick Scott told federal health officials in a letter Friday that he isn't convinced a state health exchange will lower health care costs for Floridians, and that he's worried the actual costs could end up exceeding early estimates.
The Republican governor, who has recently softened his staunch opposition to the federal health care law, requested a meeting with federal health officials in hopes of working together to set up a state health exchange to help the nearly 4 million uninsured in the state. But Scott said he needs more information before making a decision.
"Current information available to us does not offer any indication that a (Patient Protection Affordable Care Act) exchange lowers health care costs for Floridians," Scott said in a letter to Health and Human Services Secretary Kathleen Sebelius.
Start-up costs to set up the exchange from 2011 through 2013 are projected at $92.3 million for Illinois, a state with an uninsured population similar to Florida, according to Scott. The governor also noted costs could skyrocket along with enrollment in 2015 from $57.4 million to $88.6 million.
"We also have a responsibility to work toward these goals without making things worse for Florida families by driving up costs without doing anything to increase access or quality," he wrote.
Health advocates say the health exchanges and expanding Medicaid rolls would provide critical coverage for more than a million in Florida, which has one of the highest uninsured populations. The state has some of the most stringent eligibility requirements in the country for Medicaid. A family of three with income of $11,000 a year makes too much, and single residents are not covered.
The letter came the same day that Scott addressed the Federalist Society in Washington, D.C., noting, "every day when confronted with a new legislative idea or proposal, I first ask, 'how will this impact a family making $40,000 a year?'"
Scott, who made his fortune as a health care executive and once ran the nation's largest hospital chain, also strategically pushed his agenda in the letter, reminding Sebelius that the state has been waiting for more than a year for federal officials to sign off on a proposal to privatize Florida's Medicaid program.
"Statewide Medicaid managed care is one way we can act immediately to encourage more competition in health care which would drive down costs and increase outcomes and services," he wrote.
Scott has recently backed away from his harsh stance against the health care overhaul after Obama's re-election. The governor, who was one of the most vocal critics of the legislation, had previously stated that he would not go along with any parts of the health care overhaul that the state controls. Scott made his first foray into politics by forming a group called Conservatives for Patients' Rights, which ran TV ads criticizing health care reform before it was adopted by Congress.
State lawmakers sent their own letter to Sebelius on Thursday, saying they can't make a decision about whether the state will set up a health exchange because they need more details and are awaiting legislative authority.
But Senate President-designate Don Gaetz and House President-designate Rep. Will Weatherford also noted they want to secure federal money "available for detailed planning related to possible state operations of exchange functions in Florida," according to the letter.
The state needs legislative authority to make a decision, so Florida will have to wait until the group convenes in March.
States have until mid-December to notify federal authorities whether they plan to set up health insurance exchanges, an online marketplace where individuals and small businesses can shop for the most affordable coverage and where many will get help from the government to pay their premiums. If they don't run their own program, they can partner with federal officials or allow federal officials to run the program without them.
Associated Press Writer Gary Fineout contributed to this report from Tallahassee.