Lil White Lies: Seriously, Like This

“Obamacare”—the derisive pejorative used to describe the PPACA (Patient Protection and Affordable Care Act)—became operative for me this year on April Fool’s Day. As an early retiree, or someone who retired before the age of 62, my monthly premium was waived for the rest of the year starting with that date. The premiums will also be reduced for 2012. My healthcare plan also pays for certain preventative care and wellness exams which is part of the law, although it did the same before the law was enacted, due to the fact that many insurers already did so, because it’s obviously a good idea.

It should be noted I was informed of this in late 2010; in other words, my employer was preparing for this eventuality over a year ago. In March, 2011, I received an official notice of how my premiums would be covered.

Because my employer is headquartered in Michigan, the PPACA benefits were provided almost by default. A Florida State employee who was of a similar age to me, however, might have reason to be concerned about being treated differently, for example, by having benefits delayed, reduced, or blocked, looking at this ruling by PolitiFact (PF) Florida on Governor Rick Scott who’s not implementing /planning for the new healthcare law because he says “it’s not the law of the land (yet).”

PolitiFact Florida found Rick Scott “False” on that statement, because:

The Governor's Office argues the law's not "the law of the land," because several significant provisions haven't yet taken effect. But that misses the point. It's telling that the governor has resisted implementing all parts of the law, not just those slated to take effect later or that have raised constitutional questions.

My conservative counterpart (Bryan White) contends that (1) it’s not PolitiFact’s point to make (or miss), it’s Scott’s, (2) there’s no evidence that the governor has resisted implementing all parts of the law, or has “blow[n] off the federal law” as he puts it, and (3) Scott “has a good argument that provisions that have yet to take effect are not the law of the land.”

Mandatory use of seat belts is used as a (very weak) example of “I don’t have to wear my seat belt until the law goes into effect.” But the PPACA with its multiple tenets and grants is not the same as seat belts. Moreover, just wait until the person not using the seat belt gets into a severe accident—I’d be interested to hear what the insurance company has to say when the victim says “I don’t have to wear my seat belt until the law goes into effect” as an excuse for not buckling up. That is, once over the whiplash and other more serious injuries that occurred because he wasn’t wearing his seat belt.

Nevertheless, let’s start with the first item. Has Rick Scott missed the point? Is the PPACA not the law of the land until its significant provisions take effect—namely, the insurance mandate portion? Note, Scott has made a self-contradicting statement: he says it’s NOT the law of the land because he is certain the Supremes will overturn it. But if it’s not the law the law of the land, how can it be overturned?

What’s illuminating (oh no, not those light bulbs again!) is what Scott and his office are not doing as opposed to what they are doing to implement the PPACA. A graphic of where the states stand with regard to implementation above shows just where Florida is ("No legislative activity"). I don’t know what more evidence (Point Number 2) Bryan White (seriously!) wants that Scott is resisting implementation.

Take Wisconsin and Indiana, which are parties to Florida's lawsuit. Governors in both states have signed off on planning for the health care exchanges required by the federal law. In Florida, Scott has not.

What may confuse the issue is that other advocacy groups are filling the gap of informing citizens who have rights and entitlements under the new law(s), which is what a lot of the “preparation” currently consists of. Scott and his office should not be due any credit for this; it is more than clear they are opposing it.

Across the country, states are taking different approaches to implementing the health-care overhaul. But Florida is "one of the most extreme" in its reaction to the law, said Jack Meyer, an executive with Health Management Associates, a Washington consulting firm that is advising state governments on setting up health-care exchanges.

"The rhetoric I see out of Florida is more strident and totally oppositional," Meyer said. "I just think they're leaving a lot of opportunities on the table by looking at [the law] in black-and-white terms."

For those who work with senior citizens, some of the rejected funds — or those the state has declined to apply for — signal that ideology is more important than citizens' needs.

Or this: (italics added—if there’s no “preparations” required what is Rick Scott halting?)

Florida Governor Rick Scott wasted no time halting Florida’s preparations for the new federal health care overhaul after a federal judge ruled the new health care law unconstitutional.

The PolitiFact ruling also starts out with noting Scott’s opposition to the law and says this was his “justification for refusing millions of dollars in grants.” More has been added to the $25 Million to such grants refused since the graphic below dated August 1 was clipped from the New York Times:

Again, it’s not in what the state of Florida is doing to implement the law, it’s in what they’re not doing, in this case refusing to enforce the provisions now taking effect, instead deferring to the federal government:

Florida's insurance commissioner, Kevin McCarty, maintains that his agency cannot enforce any part of the federal law unless the Florida Legislature passes what's called "enabling legislation," because the federal government delegates the power to regulate insurers to the states.

And so Florida consumers can't turn to McCarty's office if their insurer refuses to insure a child under age 19 who has a pre-existing medical condition.

Nor can they turn to him if their insurer says coverage denials cannot be appealed.

Likewise, consumers can't expect help from McCarty's office if their insurance company spends less than 80 percent of their premium on benefits, as opposed to overhead, salaries and administrative costs.

Maley said the federal government will protect Floridians on that issue, too.

"If the state chooses not to enforce that, the federal government will," Maley said.

It seems to me it would be extremely difficult to get the Feds to enforce such provisions with the insurers. It would mean hiring an attorney and a lot of legal expense for someone who might not be able to afford it. In other words, the insurers and Rick Scott “win”, consumers lose. Score one more for the one percent.

So, does Scott really have “ a good argument that provisions that have yet to take effect are not the law of the land.” This was weasel-worded by Bryan White, because Scott never said anything about those “provisions”—he only said he would be ready when it’s the law of land, only he didn’t believe it would become the law of the land. And because he didn’t believe it would become the law of the land, he would not accept grants to prepare for it, would not prepare for any current provisions taking effect, and would not enforce any legal provisions currently taking effect.  But that doesn’t mean they don’t “currently” exist and therefore it’s not his duty to comply with them.

The partial list of the rejected grants can be found here, and it’s as troubling as Scott’s argument, which we can consider in turn. First, constitutionality of legislation is decided by the courts, not governors. As the leader of a state with the second highest uninsurance rate in the country and a $3.7 billion budget hole, Scott should be focused on ways to improve access to care and preserve critical health services within existing law. The money he’s turned down would have not only plugged some of the gaps in the state budget, but it would have also invested in Florida’s health care system, reduced the number of Floridians who lack coverage, eased the strain on state safety net providers who take care of the uninsured and lowered state spending on uncompensated care. Scott can consult with Mitt Romney on the advantages of financing that kind of reform with federal dollars and the two former businessmen can agree that the state — like any business — can invest money upfront to reap savings in the future.

“Constitutionality is decided by courts, not governors.” Florida by its very nature of being the state of the hanging chads that gave the 2000 election to George W. Bush—well, the Supreme Court decided the 2000 elections, and it may be that Scott knows something others don’t—that they will find some way, any way to get the PPACA totally repealed. Clarence Thomas will keep his promise to his tea partier wife Virginia as he votes in lock-step with Antonin Scalia. If they're going to allow corporations to be defined as persons, they're going to overturn Obamacare.  You betcha.  In the mean time, however, Scott doesn't have to arrogantly flaunt what he knows.

One of the reasons used for not accepting the grants is that it’s hypocrisy to accept money for something that isn’t going to happen, for something you don’t agree with in principle. But hypocrisy has never stopped Republicans before. Some of them not only took the Stimulus money they vehemently opposed, but proudly showed up at ribbon-cutting ceremonies where it was being used.

Scott has paid lip service in his “we’ll be ready for PPACA” claims. While Bryan White can say it’s true in the respect Scott’s done nothing, it’s false that he’s prepared as he says he is. It's false that it's not the law until Scott decides it is.  I guess Scott was never a Boy Scout.  Seriously.

Apparently that may be the case in Florida.