by Lexi Stemple | July 01, 2012 - FOX

Florida, the state the led the fight against President Obama's health care law, will not comply with the Supreme Court opinion.

Gov. Rick Scott tells Fox News that he and his Attorney General, Pam Bondi, will work tirelessly to make sure the law is repealed. He feels that can be done by electing officials, like Mitt Romney, who have vowed to fight the law before 2014, when most of its provisions kick in.

If that doesn't happen, Scott insists he still won't "implement these exchanges that will increase the cost of health and make Medicaid worse."

Scott claims Medicaid has been growing in Florida at three-and-half times the state's general revenue. He calls the law the "biggest job killer ever" and says Floridians cannot afford the $1.9 billion dollar increase he believes the law will cost.

Gov. Scott doesn't believe the law will go into effect in 2014. As a result, he's also not expanding his state's Medicaid program. And he says Florida can do without the federal money it will lose.

"That's still Florida taxpayers paying that," he said. "It's not like there's free federal money. Every program cuts back and you create this dependency and then they cut back like they did with our schools."

Scott claims he is not alone. He says other Republican governors like Scott Walker of Wisconsin, Rick Perry of Texas and Bobby Jindal of Louisiana are with him.

But Perry hasn't decided what he will do in Texas. Neither his office nor the state's attorney general's office would give a timetable for a decision either.

"All those decisions will be made at the appropriate time, we are assessing the impact of the decision and will explore all of our options," Perry press secretary Catherine Frazier tells Fox News.

Texas Attorney General Greg Abbott is considering other legal actions to dismantle parts of the president's health care law. But his office wouldn't give specifics, simply saying he is exploring lawsuits "against certain provisions, like the contraception mandate."

Read more: http://politics.blogs.foxnews.com/2012/07/01/gov-scott-florida-will...

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State Exchange Profiles: Arizona

As of April 9, 2012

Establishing the Exchange

Governor Jan Brewer (R) established the Office of Health Insurance Exchange to “organize the health insurance marketplace for easier evaluation by individuals and small businesses to acquire affordable health insurance.”1 In February 2012, Arizona introduced a bill to establish a state-run health insurance exchange, which remains pending in the House (HB 2783).2 Two similar bills (SB 1524, HB 2666) introduced in 2011, both failed at the close of the legislative session.3,4 Through stakeholder meetings, the Governor’s Office and legal counsel continue to research and consult on non-legislative options for establishing an exchange.

On April 24, 2010, Arizona enacted a law prohibiting plans in a state exchange from offering abortion coverage except in cases of life endangerment or severe health impairment of the pregnant woman.5

The Arizona Health Insurance Exchange Steering Committee was established to coordinate exchange planning activities across state agencies and meets regularly to ensure exchange implementation is moving forward. Members include Directors and senior staff from the Office of Health Insurance Exchange, the Department of Insurance, the Arizona Health Care Cost Containment System, the Department of Economic Security, the Department of Health Services, and the Director of Health Care Innovation Infrastructure Management.

Stakeholder feedback is gathered through five work groups including, a health plans work group led by the Department of Insurance and focused on plan management requirements; a health brokers and agents group, concentrating on broker licensing and compensation; a tribal work group, which is developing outreach and education plans; an information technology infrastructure work group led by the Arizona Health Care Cost Containment System; and a legislative work group.6 The Governor’s Office also collects exchange design and operational issues feedback from an online survey available on their website.

In collaboration with the Governor’s Office, the Arizona Department of Insurance procured subcontractors to prepare a background report, delivered in May 2011, estimating eligibility for and participation in an Arizona exchange. These estimates, along with completed Information Technology (IT) gap analyses, have assisted the state in planning for their IT infrastructure needs.7

Information Technology: Arizona plans to design and build the individual and SHOP exchange components, upgrade its Medicaid eligibility systems, and then integrate everything into one seamless, user-friendly system. The new system will also allow individuals to apply for the Supplemental Nutrition Assistance Program (SNAP) and Temporary Assistance to Needy Families (TANF). An IT Leadership Team is responsible for planning, coordinating, and implementing the IT systems and processes necessary for the exchange. The team also oversees all IT functions critical to Medicaid expansion implementation. Arizona submitted an Advanced Planning Document which was accepted by CMS, indicating the state intends to make major Medicaid eligibility systems upgrades. In 2011, the state released a Request for Information to identify viable available or proposed solutions for aligning its Medicaid and CHIP enrollment and eligibility systems with an exchange as well as estimated pricing.8

Exchange Funding

In September 2010, the Arizona Governor’s Office of Economic Recovery received a federal Exchange Planning grant of $1 million. In November 2011, the Governor’s Office was awarded a $29.8 million Level One Establishment grant to further secure IT infrastructure and assist in finalizing plan management functions for the exchange.9

Next Steps

The Department of Insurance continues to take the lead in researching and developing the plan management functions for the exchange, including certification of qualified health plans, quality rating systems, navigator programs, risk adjustment and transitional reinsurance. Their work has been informed by the health plans work group meetings. The state released a Request for Proposals soliciting subcontractor assistance with exchange management functions including, plan management, plan selection, data management and reporting, consumer support services, and financial management.10

The Governor’s legal counsel continues to research existing statutory authority to perform or contract for the exchange’s required core functions. Based on research and stakeholder consultation, Arizona intends to establish the exchange as part of an existing state agency. However, without an executive order or exchange legislation yet in place, there is an increased likelihood Arizona will not meet the federal timetable for implementation. The state has until January 1, 2013, to create a state-based exchange that the U.S. Department of Health and Human Services approves as fully or conditionally operational. If not approved, the federal government will assume responsibility for running a health insurance exchange in the state.

For more information on Arizona’s health insurance exchange planning, visit:
http://www.azgovernor.gov/hix/

Link: http://healthreform.kff.org/state-exchange-profiles/arizona.aspx

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What Liberals are Saying...

"By Harold Pollack - healthinsurance.org contributor
It’s ‘put up or shut up’ time for many red states

Although the Court’s upholding of the mandate receives the most attention, this was not a complete liberal victory. The high court also imposed new limits on the federal government’s ability to withhold Medicaid funds as a bargaining chip to influence the states. The federal government can attach all sorts of strings to new programs tied to health reform. It cannot threaten to withdraw funds from a state’s traditional Medicaid program if that state refuses to implement the pillars of health reform.

No one quite understands the long-term implications here. Right now, though, states such as Texas or Arkansas must actually decide whether they actually want to expand Medicaid as envisioned under the new law. Noting the callousness displayed by some conservative governors towards uninsured or low-income residents of their own states, liberals worry that millions of people will be left uncovered. I am less worried. The federal government will pay essentially the entire tab for newly eligible Medicaid recipients under health reform.

States which choose not to expand Medicaid would leave tens of billions of dollars on the table to make a partisan point. I don’t see conservative politicians being able to say no this money, when thousands of hospitals, nursing homes, and medical providers in their state are desperate for these funds. Indeed today’s court ruling might puncture the hypocrisy of so many red-state politicians who angrily condemn the evils of activist government while quietly accepting huge federal subsidies financed by more-affluent blue states.

Wow, the 2012 election is important

Health reform survived on a 5-4 vote in the Supreme Court. President Romney and a Republican congressional majority might well repeal the new law, Nothing in today’s decision prevents them from doing so.

Then there is the court itself. Several contending justices – liberal and conservative – are well over 70 years old. Whoever wins in 2012 may well have the opportunity to appoint three new justices. So the future of health reform – and so much else – remains in the balance."

Read full article at: http://www.healthinsurance.org/blog/2012/06/28/we-dodged-a-bullet-4...