Turnout Strategy: Florida’s War on Federal Health Care Reform Targets 2012 Ballot

Jim Saunders
Health News Florida

Florida Senate President Mike Haridopolos has an unusual way of trying to make friends and influence the federal government.

On one hand, Haridopolos and other Republican leaders want a big favor from the Obama administration: They are clamoring for more freedom in running the state Medicaid program.

But separately, Haridopolos renewed a campaign Wednesday to carve a big hole in President Obama’s signature health-care overhaul — a slap at some of the same people who hold the Medicaid purse strings.

With Haridopolos leading the charge, the Senate Health Regulation Committee approved a proposed constitutional amendment that seeks to allow Floridians to opt out of a future federal requirement that they buy health insurance. The 9-2 vote was along party lines, with Democratic Sens. Eleanor Sobel and Jeremy Ring opposed.

The House has an identical proposal, though it has not started moving through committees.

Haridopolos, R-Merritt Island, casts the proposed amendment as allowing people to make decisions about their health care. Lawmakers passed a similar proposed amendment during the 2010 legislative session, but the Supreme Court knocked it off the November ballot because of misleading wording.

“I think we believe in individual rights,” Haridopolos said.

But the issue also provides political fodder for Republicans. The amendment would be on the 2012 ballot, giving GOP voters a rallying point as President Obama runs for re-election. What’s more, Haridopolos is preparing for a possible U.S. Senate campaign in 2012, which also could place him on the ballot.

The proposed amendment targets what has become known as the “individual mandate” that the Democratic-controlled Congress and Obama included in the Patient Protection and Affordable Care Act. That mandate will require Americans to have health insurance starting in 2014 or pay a penalty.

The amendment would add language to the Florida Constitution that says, in part, “a law or rule may not compel, directly or indirectly, any person, employer or health-care provider to participate in any health-care system.”

Haridopolos’ revised proposal eliminates the wording that the Supreme Court found misleading.

Even if voters ultimately approve the amendment by the required 60-percent margin, it is debatable whether Floridians would be able to ignore the individual mandate. Some legal scholars believe the Supremacy Clause of the U.S. Constitution trumps any state opt-out attempt.

A Senate staff analysis acknowledges the proposed amendment could be subject to a legal challenge if it is perceived to conflict with the federal law. Sobel also pointed to the Supremacy Clause during the committee debate Wednesday.

“How do we resolve that issue when the state says one thing and the federal government says another thing?” the Hollywood Democrat asked.

Legislative Republicans, however, appear unified in their opposition to the individual mandate — and their willingness to take a chance on the Supremacy Clause issue.

Haridopolos and other GOP leaders take frequent public shots at what they call “Obamacare” and back a lawsuit filed by Attorney General Bill McCollum that seeks to get the federal health law declared unconstitutional.

But at the same time, Senate Republican leaders repeatedly call for the federal government to give the state more flexibility in running the Medicaid program. Haridopolos says he would like to see the federal government treat Medicaid like welfare reform in the 1990s, providing money to the state but allowing it to craft more details of how the program runs.

Such flexibility would be a departure for the federal government, and Democrats are skeptical that the Obama administration would grant it to Florida. The state would probably have to go through a lengthy waiver process to get federal approval for such a change.

Haridopolos contends that Florida will have to make deep cuts in Medicaid if it doesn’t get such flexibility. But when asked Wednesday about why the Obama administration would go along with Florida on the issue, he paraphrased a line from the president’s 2008 campaign.

“Hope — I have great hope,” he said.