Senior said AHCA is aware it will have to be a "watchdog" over managed-care organizations, looking at such things as the health plans’ finances and medical data. But while Schwartz is concerned about the overhaul, other state officials want to get federal approval of what are known as "waivers" and move forward quickly with the changes.
"I’m very concerned about the length of time it’s taken us to get the waiver,’’ said Rep. Gayle Harrell, a Stuart Republican who has long been involved in health issues.
As AHCA works to get approval, lawmakers this spring also will debate whether the state should play an active role in carrying out the Affordable Care Act.
Scott and Republican legislative leaders largely refused over the past two years to move forward with the law, which President Obama and congressional Democrats approved in 2010. But after a U.S. Supreme Court ruling in June and Obama’s re-election in November, it became clear that the Affordable Care Act will not be tossed out or repealed.
The House and Senate have formed select committees that will study issues such as whether the state should create what is known as a health-insurance exchange, which is a key part of the law’s attempt to expand coverage to millions of more Americans. Also, the committees will study issues such as a potential expansion of Medicaid eligibility in Florida.
Scott, whose opposition to the Affordable Care Act helped propel his political career, is scheduled to meet Jan. 7 with U.S. Health and Human Services Secretary Kathleen Sebelius.
He and other Republican leaders say they need more information about issues such as the insurance exchanges, which are designed to be online marketplaces where people can shop for coverage. Depending on income levels, many people will be able to receive subsidies to buy the coverage.
Florida has already missed a deadline for states that plan to operate exchanges starting in January 2014. That means, at least initially, the federal government will run an exchange in the state.
But lawmakers during the spring session will look at the possibility of operating an exchange in the future or entering into a partnership with the federal government.
The House and Senate also will discuss a series of other issues stemming from the Affordable Care Act, including whether to expand Medicaid eligibility to offer coverage to more people. The federal government would pay for the eligibility expansion from 2014 to 2016, with the state gradually picking up some of the costs after that.
In grappling with the Affordable Care Act, Scott and Republican lawmakers likely will face pressure from conservatives to avoid taking part in an exchange and the Medicaid expansion. That political pressure was evident early this month when a meeting of the Senate select committee turned raucous after a group of activists pleaded with lawmakers to not carry out the law.
But Sen. Eleanor Sobel, a Hollywood Democrat who is vice chairwoman of the select committee, said the state has to abide by the law and pointed out that Florida has one of the largest uninsured populations in the country.
"I think that needs to be reckoned with, and we need to adjust our attitudes so we make sure that everybody has health insurance and a health care policy that’s affordable and accessible,’’ Sobel said.