Of all the states that oppose the Affordable Care Act, Florida has proved the most stalwart. The state is leading the Supreme Court challenge expected to be decided this month, and has refused to take any money to implement the law. That could all change next week: Gov. Rick Scott says that, if the Supreme Court upholds Obamacare, Florida will start moving forward on implementation.
"We'll comply with the law," Scott told reporters on a conference call this morning. "If it's declared constitutional, and doesn't get repealed, we'll comply. We'll deal with all the issues we have to deal with when we know that it's going to be the law of the land."
The biggest implementation task for Florida - and any state - is setting up a health insurance exchange, the marketplace where individuals will shop for health plans. If a state does not set up its own exchange, the federal government will come in and take over the task for them.
Scott says he has yet to "make a decision on whether we'll do it at the state level or allow the federal government to do it."
Scott's plan for a world where the health reform law stands could reflect how the politics of the issue may change. The law's future has been uncertain since the day it passed, with legal threats looming large. That gave the laws' opponents a lot of space not to move forward: Why devote resources to setting up an unpopular law, the thinking goes, if it might just be torn down a few months later?
If the Supreme Court upholds the Affordable Care Act, a lot of that uncertainty goes away. States have choices to make, about whether they will run their insurance marketplace or turn the task over to the feds. Doing nothing quickly becomes a less prudent option. States that oppose the law, like Florida, may soon find themselves on the other side of a choice between lesser evils, deciding to move forward.