"In this case, the Constitution's limits on government power did not fail," Bondi said at the Florida Chamber of Commerce's annual insurance summit. "Political accountability failed because the president and supporters of this law apparently were not straight with the American people."
It's that attitude that continues to concern Florida health-care advocates, and today representatives from 20 such groups sent a letter to Health & Human Services (HHS) Secretary Kathleen Sebelius, requesting that her department begin the implementation of a health care exchange and that it be transparent and accountable with meaningful public participation.
The letter calls for HHS to do four things regarding Florida and the Health Care Act:
1. HHS should impose reasonable limits on state flexibility in order to ensure predictability that is essential to planning, public education, and outreach efforts.
2. HHS should conduct a reality-based assessment of the capacity of a state to perform its proposed responsibilities within any proposed Partnership Exchange model, and be prepared to require that Florida default to an FFE initially if that is the only viable option.
3. HHS should ensure/require full transparency and ongoing opportunities for meaningful public participation in all exchange-related program and policy decisions, regardless of whether Florida is served by a Partnership Exchange or an FFE.
4. HHS should establish and enforce strong accountability standards in the areas of public participation, consumer assistance and protection, and Qualified Health Plan performance.
In addition, two groups, Florida CHAIN and Progress Florida, have created a petition that will be sent to Secretary Sebelius, calling on her to "Stay Strong" and ignore the "ruthless partisan agenda that Governor Scott has made it clear he will continue" regarding the implementation of the ACA.
Progress Florida's Darden Rice said 8,800 petitions have already been sent electronically to Secretary Sebelius.
Federal law requires that everyone be eligible to sign up for an exchange by Jan. 1, 2014. The deadline for states to show they can run their own exchange is just weeks away (Dec. 14).
"To date, Florida has not had one public meeting, established one rule or guideline, or invested in any public dollars into an effort that has taken other states years, and hundreds of millions of dollars to do," said Laurie Goodhue with Florida CHAIN.
The second model offered by the Obama administration is a joint state-federal exchange. The deadline to announce the state wants to go that route is on Feb.14, 2013. "This is not feasible, and would also be a recipe for failure at this time," Goodhue said.
Laura Brennaman, a registered nurse and health advocate, said she was passionate that the Department of Health and Human Services should not offer Florida any extra time or waivers, simply because they've come so late to the negotiating table.
Rice echoed that sentiment, calling on Secretary Sebelius to not allow Florida "any wiggle room."
Advocates say realistically that answer depends because there are so many potential obstacles. It may not be until 2015 that there's a state run exchange, but a partnership with the government could be implemented sooner.