FORT LAUDERDALE — Dozens of tea party activists and conservative religious leaders flooded a state Senate meeting on the Affordable Care Act on Monday, calling the law a gross overreach by the federal government and begging lawmakers not to implement it.
The first meeting of the Senate Select Committee on Patient Protection and Affordable Care Act, chaired by Republican Sen. Joe Negron, was a fiery one as lawmakers discussed what will be one of the most critical and contentious issues of the upcoming legislative session.
The state must decide whether to expand its Medicaid rolls to offer coverage to more residents and whether to set up a state-run health exchange or allow the federal government to run the program. Republican Gov. Rick Scott has been a vocal critic of the health care law. He softened his stance after the election, signaling he wants to work together with the feds, but is worried about the cost to taxpayers.
A rowdy conservative crowd commandeered a nearly hour-long public comment section, stressing that the constitution does not grant the federal government the authority to make health care decisions, despite a U.S. Supreme Court ruling that upheld most of the health care law. All but one spoke against “Obamacare.”
“We will not comply with this unlawful mandate,” Pastor James Hall of the Baptist Coalition of North Florida said to rousing applause.
Constitutional attorney Krisanne Hall said she travels the country talking to citizens and religious groups who echo that sentiment. She asked the Senate committee to consider how it will deal with citizens “when they lawfully and constitutionally stand and say we will not comply.”
Democratic Senate Minority leader Chris Smith was booed when he reminded the crowd that the federal government stepped in to uphold justice in civil rights cases.
“Our Constitution is an imperfect document. If it was perfect it would not have amendments to it. The Constitution had to be amended through time.”
“Sometimes you need change and I look forward to looking at this law,” he said.
The committee made no decisions Monday and lawmakers gave little indication of what they might decide.
The state has until Dec. 14 to tell federal officials if it will set up its own health exchange, an online marketplace where residents and small businesses can shop for health care coverage. The state can also partner with the federal government on an exchange or allow the feds to run the program entirely.
One of the most critical decisions will be whether Florida decides to expand its Medicaid rolls to offer coverage to more residents. The Obama administration is offering to absorb the cost for the first three years and pick up 90 percent of the tab after that.
Florida has one of the highest rates of uninsured residents and some of the most stringent eligibility requirements in the country for Medicaid. A family of three with an income of $11,000 a year makes too much and single residents are not covered.
Officials estimate close to 900,000 residents could be covered under expanded Medicaid rolls by fiscal year 2020-2021, costing the state $330 million.
But a committee adviser said federal officials have indicated that states might be allowed to partially expand the rolls — which could cost less. For example, instead of offering coverage for residents who qualify up to 138 percent of the poverty level, the state could choose to expand coverage at a lower percentage.
States can also retract their expansion at any time.
“If we didn’t expand Medicaid there’s the potential that people that would have been covered under Medicaid expansion could in fact be covered through the exchange through some type of subsidy,” said Negron.
He reminded the committee that the state will spend about $21 billion on Medicaid this year. Medicaid covers nearly 3 million people. About half are children. Lawmakers say Medicaid must be overhauled because it’s eating up about 30 percent of the state budget.
“It’s crowded out our ability to fund high education, transportation and other equally valid and worthy parts of our budget,” said Negron, who spearheaded the 2011 passage of two historic bills that privatized Medicaid statewide.
The state is still waiting for federal officials to sign off on that request.
Sen. Eleanor Sobel, D-Hollywood, also stressed the state’s high rates of uninsured residents.
“I think that needs to be reckoned with and we need to adjust our attitudes so we make sure that everyone has health insurance ... that’s affordable and accessible,” she said.