TAMPA - Dr. Jay Wolfson, Vice President of Health at the University of South Florida, has been following the roll-out of Affordable Care Act provisions. He says decisions, made both in Washington and in Tallahassee in the next few months, will have a heavy impact on all of us.
That's because two of the biggest provisions in the act - the expansion of Medicaid and the creation of health insurance exchanges - require state participation. "Some states have made tremendous progress in setting them up. Florida is not one of them."
The reason? Wolfson says the Republican-led state government is at odds with the federal government over how to pay for these plans and how they will be implemented at the state level.
Let's start with the health insurance exchange - basically an online market where people will be able to shop for insurance coverage. "We'll have a choice what kind of package we want. They can be low level coverage with a high deductible. They can be high level coverage with a low deductible, or something in between, depending on what we can afford and what we think we need.
And there are federal assistance plans available for people of different incomes to help people buy those things.
But a decision has to be made by the state as to whether the state wants to manage and implement these exchanges, whether it wants to contract with private entities to do that or whether it wants the federal government to do it."
Lawmakers are likely to decide this spring but Florida has already missed a deadline that officials say virtually assures the federal government will run Florida's exchange when it takes effect in January 2014.
Another one of the biggest provisions in the AHCA: the expansion of Medicaid. Wolfson says, "Medicaid is health insurance for the medically indigent."
Starting in 2014, Floridians won't have to be quite as poor to qualify for Medicaid which would open the insurance program to an estimated 1.2 million previously uninsured Floridians.
The federal government will pay for the entire plan the first three years and cover 90 percent after that. Florida's governor opposed the plan, saying the expansion will eventually cost Florida taxpayers billions of dollars. If the two sides fail to find a common ground, Wolfson says, "The average Floridians who does have coverage may still be affected, even if they're not Medicaid eligible, that's because the people who would be affected by an expansion are going to go to emergency rooms for care and free clinics for care and the cost of those things are going to be shifted to our private insurance policies."
If Florida refuses the federal funds for expansion, Wolfson says, "Some other state will get the money. Sure. There's no requirement that any state expand its Medicaid to 133 percent."
We're keeping our eye on what's happening in both Tallahassee and Washington.
If you want more detailed information on the Affordable Care Act, including a time line that tells you what is rolling out when, go to http://www.healthcare.gov/law/timeline