statesThe list of states opting out of two major provisions of the Patient Protection and Affordable Care Act (PPACA) has expanded to three, now including Louisiana, Wisconsin, and most recently Florida. All three states have rejected plans to expand current Medicaid programs and have opted not to create health insurances exchanges. Such actions are legal given the decision of the Supreme Court to not allow the federal government from withholding federal Medicaid funds to states electing not to participate in health reform provisions.

The states will still be required to have its own public insurance exchange but are not required to set it up themselves and don’t have to accommodate for private exchanges. The law stipulates that states refusing to create their own exchanges must allow the federal government to step in and create one for them.

Florida’s argument against the provisions, similar to those of the other two states, is that expanding Medicaid will cost more than the state is willing to pay and that it already offers programs that offer coverage options similar to those that would be present after Medicate expansion. The state stands by the argument despite the offer by the U.S. government to cover 90 percent of the cost increase. Florida Governor Rick Scott said that not only would Medicaid expansion be redundant and cost $1.9 billion, but health insurance premiums would rise on any insurance exchange.

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